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https://www.readbyqxmd.com/read/28321346/a-perplexing-case-of-abdominal-pain-that-led-to-the-diagnosis-of-zollinger-ellison-syndrome
#1
Adrienne Lenhart, Mona Hassan, Alireza Meighani, Omar Sadiq, Yousuf Siddiqui
Zollinger-Ellison syndrome (ZES) is a rare clinical disorder, characterized by hypersecretion of gastric acid and multiple ulcers distal to the duodenal bulb. This occurs via the release of gastrin by neuroendocrine tumors known as gastrinomas. Patients with ZES present with nonspecific GI symptoms, which often leads to a delay in diagnosis. Our patient is a 55-year-old female with chronic abdominal pain, nausea, and diarrhea. She underwent EGD, EUS, MRCP, CT scans, and cholecystectomy, which did not reveal the cause of her symptoms...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28321165/fibrin-sealant-for-closure-of-mucosal-penetration-at-the-cardia-during-peroral-endoscopic-myotomy-a-retrospective-study-at-a-single-center
#2
Wen-Gang Zhang, En-Qiang Linghu, Hui-Kai Li
AIM: To assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia during peroral endoscopic myotomy (POEM). METHODS: Twenty-four patients who underwent POEM and experienced mucosal injury of the cardia during the procedure were retrospectively identified. Of the 24 patients, 21 had mucosal penetration and 3 had only slight mucosal damage without penetration. The 21 patients with mucosal penetration received fibrin sealant for closure at the site of penetration...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28316930/transudative-pleural-effusion-of-malignant-etiology-rare-but-real
#3
Lindsey Johnson, Hafiz Abdul Moiz Fakih, Salim Daouk, Shaheera Saleem, Ali Ataya
A 62-year-old female presented to the emergency room with one-month history of epigastric abdominal pain, nausea and vomiting. She endorsed progressive dyspnea over two weeks. CT of the abdomen demonstrated bilateral pleural effusions and pancreatic inflammation, so the working diagnosis was pancreatitis. A diagnostic thoracentesis was performed and the pleural fluid analysis was classified as transudate by Light's criteria. Given the atypical features in history and concern for malignancy, fluid was sent for cytological examination and immunohistochemistry which suggested a mucinous malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28303607/esophageal-keratinous-inclusion-cyst
#4
Keiichi Hashiguchi, Kazuo Ohba, Masahiro Nakashima
A 68-year-old man was evaluated for an esophageal submucosal tumor (SMT). The esophageal SMT had been incidentally identified 3 years previously on esophagogastroduodenoscopy (EGD) during cancer screening, and had increased in size on subsequent follow-ups, although the patient had no symptoms. EGD at our hospital revealed a yellowish elevated 9-mm lesion, covered by normal squamous epithelium in the middle of the esophagus (Fig. 1A). The tumor had a negative cushion sign. Endoscopic ultrasonography revealed an isoechoic mass in the lamina propria (Fig...
March 16, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28302442/symptoms-endoscopic-findings-and-reflux-monitoring-results-in-candidates-for-bariatric-surgery
#5
Benjamin Heimgartner, Marcus Herzig, Yves Borbély, Dino Kröll, Philipp Nett, Radu Tutuian
BACKGROUND: Gastroesophageal reflux disease (GERD) is common in patients with obesity. Diagnosing GERD is important as bariatric operations have different influence on GERD. We assessed reflux symptoms and objective findings prior to surgery. METHODS: Work-up included esophageal symptoms quantification by VAS-scores, esophagogastroduodenoscopy (EGD) and 24-h impedance-pH (imp-pH) monitoring off PPI therapy. Imp-pH was classified as abnormal if either %time pH<4 was abnormal, total number of reflux episodes was elevated or symptom index (SI) was positive...
February 3, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28291239/cap-assisted-upper-endoscopy-for-examination-of-the-major-duodenal-papilla-a-randomized-blinded-controlled-crossover-study-cappa-study
#6
Mohamed Abdelhafez, Veit Phillip, Alexander Hapfelmeier, Mayada Elnegouly, Alexander Poszler, Kilian Strobel, Peter Born, Markus Dollhopf, Abdel Meguid Kassem, Lenika Calavrezos, Peter Klare, Christoph Schlag, Monther Bajbouj, Roland M Schmid, Stefan von Delius
OBJECTIVE: Examination of major duodenal papilla (MDP) by standard forward-viewing esophagogastroduodenoscopy (S-EGD) is limited. Cap assisted esophagogastroduodenoscopy (CA-EGD) utilizes a cap fitted to the tip of the endoscope that can depress the mucosal folds and thus might improve visualization of MDP. The aim of this study was to compare CA-EGD to S-EGD for complete examination of the MDP. METHODS: Prospective, randomized, blinded, controlled crossover study...
March 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28286937/early-versus-late-bedside-endoscopy-for-gastrointestinal-bleeding-in-critically-ill-patients
#7
Jee Hyun Kim, Ji Hye Kim, Jaeyoung Chun, Changhyun Lee, Jong Pil Im, Joo Sung Kim
Background/Aims: Gastrointestinal (GI) bleeding is a life-threatening complication in critically ill patients. The aim of this study was to determine the efficacy of bedside endoscopy in an intensive care unit (ICU) setting, and to compare the outcomes of early endoscopy (within 24 hours of detecting GI bleeding) with late endoscopy (after 24 hours). Methods: We retrospectively reviewed the medical records of patients who underwent bedside endoscopy for nonvariceal upper GI bleeding and lower GI bleeding that occurred after ICU admission at Seoul National University Hospital from January 2010 to May 2015...
March 15, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28275018/brunner-s-gland-hamartoma-a-rare-cause-of-iron-deficiency-anaemia-and-report-of-an-adapted-colonic-polyp-resection-technique
#8
Stephanie Judd, Suhag Patel, Edi Levi, Fadi Antaki
A man aged 65 years presented with symptomatic anaemia without overt gastrointestinal bleeding. An oesophagogastroduodenoscopy (EGD) was performed and he was found to have a large ulcerated pedunculated Brunner's gland hamartoma in the duodenal bulb. The polyp was resected using snare cautery in forward and retroflexed positions. Colonoscopy was also performed and a few diminutive polyps were resected. A year later, the patient returned for a surveillance EGD, and no residual polyp was noted. Haemoglobin and iron studies normalised within a few months after polypectomy, with resolution of symptoms...
March 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28261507/endoscopic-appearance-of-oropharyngeal-and-upper-gi-kaposi-s-sarcoma-in-an-immunocompromised-patient
#9
Umar Darr, Anas Renno, Zubair Khan, Turki Alkully, Maitham A Moslim, Sehrish Kamal, Ali Nawras
Introduction. Kaposi's sarcoma (KS) usually manifests as a cutaneous disease but GI manifestation is often rare. It is associated with human herpes virus-8 (HHV-8) and seen in immunocompromised patients. In the USA, use of highly active antiretroviral therapy (HAART) has drastically reduced incidence of KS in HIV patients. Case Presentation. A 65-year-old male with human immunodeficiency virus (HIV) was admitted to the intensive care unit (ICU) with cardiopulmonary arrest secondary to hyperkalemia of 7.5 meq/L...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28250898/gastric-intestinal-metaplasia-is-associated-with-gastric-dysplasia-but-is-inversely-correlated-with-esophageal-dysplasia
#10
Justin M Gomez, James T Patrie, Wissam Bleibel, Jeanetta W Frye, Bryan G Sauer, Vanessa M Shami, Edward B Stelow, Christopher A Moskaluk, Andrew Y Wang
AIM: To determine which clinical factors might be associated with gastric intestinal metaplasia (IM) in a North American population. METHODS: Pathology and endoscopy databases at an academic medical center were reviewed to identify patients with and without gastric IM on biopsies for a retrospective cohort study. Patient demographics, insurance status, and other clinical factors were reviewed. RESULTS: Four hundred and sixty-eight patients with gastric IM (mean age: 61...
February 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28246484/how-to-improve-patient-satisfaction-during-midazolam-sedation-for-gastrointestinal-endoscopy
#11
Eun Hyo Jin, Kyoung Sup Hong, Young Lee, Ji Yeon Seo, Ji Min Choi, Jaeyoung Chun, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung
AIM: To determine the procedure-related factors that affect sedation satisfaction and to make a suggestion to improve it. METHODS: We prospectively enrolled a total of 456 patients who underwent outpatient endoscopy procedures with midazolam sedation between March 2014 and August 2014. All patients completed both pre- and post-endoscopy questionnaires about sedation expectations and satisfaction. RESULTS: The study cohort included 167 (36...
February 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28244499/the-annual-risk-of-esophageal-adenocarcinoma-does-not-decrease-over-time-in-patients-with-barrett-s-esophagus
#12
Theresa Nguyen, Aaron P Thrift, Xiaoying Yu, Zhigang Duan, Hashem B El-Serag
OBJECTIVES: Endoscopic surveillance is recommended for patients with Barrett's esophagus (BE). However, it remains unclear if all BE patients benefit from long-term surveillance. We investigated the risk of esophageal adenocarcinoma (EAC) in BE patients in relation to number of successive endoscopies, years of follow-up, and calendar year. METHODS: We conducted a retrospective cohort study of male veterans with newly diagnosed BE during 2004-2009 with follow-up until 30 September 2011...
February 28, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28243860/upper-gastrointestinal-endoscopy-prior-to-bariatric-surgery-mandatory-or-expendable-an-analysis-of-801-cases
#13
Stefan Wolter, Anna Duprée, Jameel Miro, Cornelia Schroeder, Marie-Isabelle Jansen, Clarissa Schulze-Zur-Wiesch, Stefan Groth, Jakob Izbicki, Oliver Mann, Philipp Busch
BACKGROUND: Upper gastrointestinal pathologies are common in bariatric patients. Preoperative esophagogastroduodenal endoscopy (EGD) should detect and treat pathologies that might alter the type of bariatric surgery. However, clinical consequences of these findings are often insignificant. The aim of this study was to assess the influence of preoperative endoscopy in our cohort and its clinical consequences. METHODS: We conducted a retrospective analysis of endoscopic findings in patients under evaluation for bariatric surgery...
February 27, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28219358/mst-4-and-traf-6-expression-in-the-peripheral-blood-mononuclear-cells-of-patients-with-graves-disease-and-its-significance
#14
COMPARATIVE STUDY
Ai Guo, Yan Tan, Chun Liu, Xiaoya Zheng
BACKGROUND: MST-4 and TRAF-6 are involved in the regulation of inflammatory and immune responses. However, whether they participate in the pathogenesis of Graves' disease (GD) has not yet been reported. Therefore, the purpose of this study was to investigate the expression of MST-4 and TRAF-6 in the peripheral blood of patients with GD to understand their role in the pathogenesis of GD. METHODS: Thirty newly diagnosed GD patients, 24 GD patients in remission (eGD) and 30 normal controls (NC) were recruited...
February 20, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28211094/comparison-of-procedural-sequences-in-same-day-painless-bidirectional-endoscopy-a-single-center-prospective-randomized-study
#15
Yan Cao, Jun Yang, Jiao Li, Xin Ao, Kai-Yuan Zhang, Xiao-Chun Shen, Dong-Feng Chen, Chun-Hui Lan
AIMS: To compare the efficacy and safety of esophagogastroduodenoscopy (EGD)-colonoscopy and colonoscopy-EGD sequences for patients subjected to same-day bidirectional endoscopy under remifentanil and propofol sedation. METHOD: A total of 209 eligible outpatients scheduled for diagnostic same-day bidirectional endoscopy between February 16, 2016 and April 30, 2016 were randomly assigned to the EGD-colonoscopy (n=106) and colonoscopy-EGD (n=103) sequence groups. The primary endpoint was the total dose of propofol required for the procedure...
February 17, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28199762/improving-the-diagnostic-criteria-for-primary-liver-graft-non-function-in-adults-utilizing-standard-and-transportable-laboratory-parameters-an-outcome-based-analysis
#16
Mohammad A B Al-Freah, Mark J W McPhail, Elena Dionigi, Matthew R Foxton, Georg Auzinger, Mohamed Rela, Julia A Wendon, John G O'Grady, Michael A Heneghan, Nigel D Heaton, William Bernal
Current diagnostic criteria for primary non-function (PNF) of liver grafts are based on clinical experience rather than statistical methods. A retrospective, single centre study was conducted of all adults (n=1,286) who underwent primary liver transplant 2000-2008 in our centre. Laboratory variable during the first post-liver transplant week were analysed. Forty two patients (3.7%) had 2-week graft failure. Transplant albumin, day-1 AST, day-1 lactate, day-3 bilirubin, day-3 INR and day-7 AST were independently associated with PNF on multivariate logistic regression...
February 15, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28199146/morphological-change-and-decreasing-transfer-rate-of-biofilm-featured-listeria-monocytogenes-egde
#17
Yuejia Lee, Chinling Wang
Listeria monocytogenes , a lethal foodborne pathogen, has the ability to resist the hostile food processing environment and thus frequently contaminates ready-to-eat foods during processing. It is commonly accepted that the tendency of L. monocytogenes ' to generate biofilms on various surfaces enhances its resistance to the harshness of the food processing environment. However, the role of biofilm formation in the transferability of L. monocytogenes EGDe remains controversial. We examined the growth of Listeria biofilms on stainless steel surfaces and their effect on the transferability of L...
February 15, 2017: Journal of Food Protection
https://www.readbyqxmd.com/read/28191357/metastatic-invasive-lobular-breast-cancer-presenting-clinically-with-esophageal-dysphagia
#18
Lilit Karapetyan, Heather Laird-Fick, Reuben Cuison
Background. Intra-abdominal metastases of invasive lobular breast cancer (ILBC) may be insidious. We report a case of metastatic ILBC that presented with dysphagia within weeks of a negative mammogram and before the development of intra-abdominal symptoms. Case. A 70-year-old female developed esophageal dysphagia. She underwent EGD which showed a short segment of stricture of the distal esophagus without significant mucosal changes. Biopsy was unremarkable and patient underwent lower esophageal sphincter (LES) dilation...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28188978/split-dose-bowel-preparation-with-polyethylene-glycol-for-colonoscopy-performed-under-propofol-sedation-is-there-an-optimal-timing
#19
Alaa Alghamry, Sureshkumar K Ponnuswamy, Aditya Agarwal, Hadi Moattar, Stephanie T Yerkovich, Ann E Vandeleur, James Thomas, John Croese, Tony Rahman, Ruth Hodgson
AIM: Aspiration risk, especially with propofol sedation, remains a concern with split-dose bowel preparation using polyethylene glycol, which involves up to one liter of preparation intake close to the procedure time. We aim to identify the ideal timing of bowel preparation that achieves optimal colon cleansing with no increased risk of aspiration in all patients undergoing combined esophagogastroduodenoscopy (EGD) and colonoscopy with propofol sedation. METHODS: We prospectively recruited 892 consecutive patients undergoing simultaneous EGD and colonoscopy...
February 11, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28185152/incidental-finding-of-gastrointestinal-stromal-tumors-during-laparoscopic-sleeve-gastrectomy-in-obese-patients
#20
Germán Viscido, Franco Signorini, Luciano Navarro, Mario Campazzo, Patricia Saleg, Verónica Gorodner, Lucio Obeide, Federico Moser
INTRODUCTION: The frequency of incidental pathology found during laparoscopic bariatric surgery has been estimated to be 2%. Gastrointestinal stromal tumors (GISTs) are infrequent lesions and account for less than 1% of all digestive tract tumors. The reported incidence of this type of tumors during bariatric surgery is around 0.8%. The objective of this study was to evaluate incidence, characteristics, and evolution of incidentally found GISTs in patients undergoing laparoscopic sleeve gastrectomy (LSG) for the treatment of obesity...
February 9, 2017: Obesity Surgery
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