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https://www.readbyqxmd.com/read/28426901/a-case-of-toxic-epidermal-necrolysis-and-vanishing-bile-duct-syndrome-requiring-liver-transplantation
#1
Sophie Momen, Carol Dangiosse, Emma Wedgeworth, Sarah Walsh, Daniel Creamer
A 52-year-old woman presented with a five-day history of headache, fevers and a diffuse, macular erythematous rash. Ten days prior she received cephalexin for a urinary-tract infection. She had a history of gastro-oesophageal reflux disorder and took omeprazole. This article is protected by copyright. All rights reserved.
April 20, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28425658/endoscopic-management-of-acute-cholangitis-as-a-result-of-common-bile-duct-stones
#2
Mohan Ramchandani, Partha Pal, D Nageshwar Reddy
Acute cholangitis is infectious disease of the biliary system and potentially can cause significant morbidity and mortality. With advances in intensive care, antibiotic therapy advances and endoscopic and other modalities of biliary drainage, mortality rates have significantly come down of late. Although most cases respond to antibiotics alone, definitive therapy is required later in most of the patients. Increased biliary pressure leads to biliovenous reflux of bacteria and purulent bile into the circulation leading to systemic inflammation and sepsis with subsequent organ dysfunction...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28378207/laparoscopic-silastic-ring-mini-gastric-bypass-sr-mgbp-up-to-11-year-results-from-a-single-centre
#3
Laila Sheikh, Lyn A Pearless, Michael Wc Booth
BACKGROUND: Bariatric surgery is well established as an effective method for treating obesity and its related comorbidities. The laparoscopic mini-gastric bypass (MGBP) represents a simpler alternative to a Roux-en-Y gastric bypass (RYGBP). The placement of a silastic ring (SR) may enhance excess weight loss and minimize weight regain. This study reports long-term results from a cohort of patients undergoing a SR-MGBP in a single centre. METHODS: Long-term outcomes (up to 11 years) in a cohort of 156 patients undergoing surgery between August 2005 and January 2008 were analysed...
April 4, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28344983/effects-of-bile-acids-on-human-airway-epithelial-cells-implications-for-aerodigestive-diseases
#4
Adil Aldhahrani, Bernard Verdon, Chris Ward, Jeffery Pearson
Gastro-oesophageal reflux and aspiration have been associated with chronic and end-stage lung disease and with allograft injury following lung transplantation. This raises the possibility that bile acids may cause lung injury by damaging airway epithelium. The aim of this study was to investigate the effect of bile acid challenge using the immortalised human bronchial epithelial cell line (BEAS-2B). The immortalised human bronchial epithelial cell line (BEAS-2B) was cultured. A 48-h challenge evaluated the effect of individual primary and secondary bile acids...
January 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28341659/chronic-microaspiration-of-bile-acids-induces-lung-fibrosis-through-multiple-mechanisms-in-rats
#5
Bi Chen, Wen Jie You, Xue Qing Liu, Shan Xue, Hui Qin, Han Dong Jiang
Gastroesophageal reflux (GER) and microaspiration of duodenogastric refluxate have been recognized as a risk factor for pulmonary fibrosis. Recent evidence suggests that bile acid microaspiration may contribute to the development of lung fibrosis. However, the molecular evidence is scarce and the underlying mechanisms remain to be elucidated. We have recently demonstrated that bile acids induce activation of alveolar epithelial cells (AECs) and lung fibroblasts in vitro In the present study, a rat model of bile acid microaspiration was established by weekly intratracheal instillation of three major bile acids including chenodeoxycholic acid (CDCA), deoxycholic acid (DCA), and lithocholic acid (LCA)...
May 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28336546/barrett-s-metaplasia-develops-from-cellular-reprograming-of-esophageal-squamous-epithelium-due-to-gastroesophageal-reflux
#6
Carlos D Minacapelli, Manisha Bajpai, Xin Geng, Christina L Cheng, Abhishek A Chouthai, Rhonda F Souza, Stuart Jon Spechler, Kiron M Das
OBJECTIVE: Gastroesophageal reflux disease (GERD) clinically predisposes to columnar Barrett's metaplasia (BM) in the distal esophagus. We demonstrate evidence supporting cellular origin of BM from reprograming or trans-commitment of resident normal esophageal squamous (NES) epithelial cells in response to acid and bile exposure using an in vitro cell culture model. DESIGN: The hTERT-immortalized NES cell line, NES-B10T, was exposed 5 min/day to Acid and Bile (A+B) mixture for 30 weeks...
March 23, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/28325187/postgastrectomy-syndromes-and-nutritional-considerations-following-gastric-surgery
#7
REVIEW
Jeremy L Davis, R Taylor Ripley
Postgastrectomy syndromes result from altered form and function of the stomach. Gastrectomy disrupts reservoir capacity, mechanical digestion and gastric emptying. Early recognition of symptoms with prompt evaluation and treatment is essential. Many syndromes resolve with minimal intervention or dietary modifications. Re-operation is not common but often warranted for afferent and efferent loop syndromes and bile reflux gastritis. Preoperative nutritional assessment and treatment of common vitamin and mineral deficiencies after gastrectomy can reduce the incidence of chronic complications...
April 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28303507/laparoscopic-conversion-of-one-anastomosis-gastric-bypass-to-a-standard-roux-en-y-gastric-bypass
#8
Imed Ben Amor, Niccolo Petrucciani, Radwan Kassir, Abdullah Al Munifi, Thierry Piche, Tarek Debs, Jean Gugenheim
INTRODUCTION: One anastomosis gastric bypass (OAGB) demonstrated results similar to traditional Roux-en-Y procedures [1-3], in terms of weight loss and resolution of obesity-related comorbidities. The main controversy regarding OAGB is the concern for an association between biliary alkaline gastritis and esophageal or gastric cancer raised by some studies [4]. METHODS: We present the case of a 51-year-old woman with a BMI of 41 kg/m2 who underwent a laparoscopic OAGB in 2014...
March 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28289881/modified-biliary-enteric-anastomosis-for-congenital-choledochal-cyst-clinical-and-prognostic-analysis-of-91-cases
#9
Ji Chen, Bin Jiang, Jun Yi, Lei Huang, Xinmin Si
PURPOSE: To report our experience with a modified biliary-enteric anastomosis procedure for the surgical treatment of congenital choledochal cysts. METHODS: Between January 2009 and December 2013, 91 children (19 boys, 72 girls; ages, 6-145 months) with congenital choledochal cysts were treated with our modified surgical procedure in our hospital. Of these patients, 69 had type I cysts, and 22 had type IV B cysts. The main parameters analyzed mainly included the operative time, duration of bowel recovery, resumption of diet, postoperative hospital stay, liver-function tests, postoperative complications, and prognosis...
June 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28263463/drug-and-drug-abuse-associated-hyperbilirubinemia-experience-with-atazanavir
#10
Jayanta Roy-Chowdhury, Namita Roy-Chowdhury, Irving Listowsky, Allan W Wolkoff
Hyperbilirubinemia is a common finding in individuals with a history of substance abuse. Although this may indicate a serious disorder of liver function, this is not always the case. An understanding of bilirubin formation, metabolism, and transport can provide a helpful approach to dealing with these patients. This is typified by studies of patients treated with the antiretroviral drug atazanavir. Atazanavir has been associated with hyperbilirubinemia in as many as one-third of individuals for whom it has been prescribed, evoking concerns of hepatotoxicity...
March 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28261701/cholangiocarcinoma-in-choledochal-cyst-after-cystoenterostomy-how-a-mistreated-choledochal-cyst-can-progress-to-malignancy
#11
HyungJoo Baik, Yo-Han Park, Sang Hyuk Seo, Min Sung An, Kwang Hee Kim, Ki Beom Bae, Chang Soo Choi, Sang Hoon Oh, Young Kil Choi
This case report presents an unusual case of cholangiocarcinoma arising nearly 35 years after cystoduodenostomy for choledochal cyst. The patient visited our hospital with dyspepsia and studies revealed bezoar within the choledochal cyst caused by bile and food reflux. The patient underwent pancreaticoduodenectomy and a biopsy revealed adenocarcinoma, stage IIB. After 19 months, the patient has no recurrence to date and has recovered well. This case shows that proper surgical management and meticulous, long-term follow-up is imperative for patients with congenital choledochal cyst...
November 2016: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28251844/overview-of-pathophysiological-features-of-gerd
#12
Paolo Usai Satta, Francesco Oppia, Francesco Cabras
Gastro-esophageal reflux disease (GERD) is a very prevalent condition and has a high impact on the quality of life. Nevertheless, pathophysiology is complex and multi-factorial. Several mechanisms have been proposed: decreased salivation, decreased lower esophageal sphincter pressure resting tone, presence of hiatal hernia, increased number of transient lower esophageal sphincter relaxations, increased acid, and pepsin secretion, duodeno-gastro-esophageal reflux of bile acids and trypsin. Other factors contributing to the pathophysiology of GERD include poor esophageal clearance, delayed gastric emptying and impaired mucosal defensive factors...
March 1, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28240637/correlation-between-bile-reflux-gastritis-and-biliary-excreted-contrast-media-in-the-stomach
#13
Jong Jin Hyun, Suk Keu Yeom, Euddeum Shim, Jaehyung Cha, Inyoung Choi, Seung Hwa Lee, Hwan Hoon Chung, Sang Hoon Cha, Chang Hee Lee
OBJECTIVE: This study aimed to evaluate the relationship between biliary excreted contrast media in the stomach and the presence of bile reflux gastritis. METHODS: Consecutive 111 patients who underwent both gadoxetic acid-enhanced magnetic resonance cholangiography (gadoxetic MRC) and gastric endoscopy were included in this study. We performed a review of the gadoxetic-MRC image sets acquired 60 minutes after intravenous injection of contrast media and endoscopic images...
February 24, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28229343/a-case-of-pancreaticobiliary-maljunction-with-a-connecting-duct-without-a-long-common-channel
#14
Masataka Kikuyama, Terumi Kamisawa, Sawako Kuruma, Kazuro Chiba, Satomi Koizumi, Taku Tabata, Goro Honda
Pancreaticobiliary maljunction (PBM) is a congenital malformation in which the pancreatic and bile ducts join anatomically outside the duodenal wall, usually forming an abnormally long common channel. In PBM, since the long common channel defeats the effect of the sphincter of Oddi, pancreatobiliary reflux frequently occurs, resulting in high rates of biliary tract cancers. We present the case of a 68-year-old female with advanced gallbladder cancer concomitant with bile duct cancer associated with PBM without biliary dilatation that had an extremely rare configuration showing a connecting duct without a long common channel...
April 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28226350/-value-of-endoscopy-application-in-the-management-of-complications-after-radical-gastrectomy-for-gastric-cancer
#15
Yiqun Zhang, Pinghong Zhou
Endoscopy plays an important role in the diagnosis and treatment of postoperative complications of gastric cancer. Endoscopic intervention can avoid the second operation and has attracted wide attention. Early gastric anastomotic bleeding after gastrectomy is the most common. With the development of technology, emergency endoscopy and endoscopic hemostasis provide a new treatment approach. According to the specific circumstances, endoscopists can choose metal clamp to stop bleeding, electrocoagulation hemostasis, local injection of epinephrine or sclerotherapy agents, and spraying specific hemostatic agents...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28223834/bile-salt-receptor-tgr5-is-highly-expressed-in-esophageal-adenocarcinoma-and-precancerous-lesions-with-significantly-worse-overall-survival-and-gender-differences
#16
Chunhong Pang, Amy LaLonde, Tony E Godfrey, Jianwen Que, Jun Sun, Tong Tong Wu, Zhongren Zhou
Bile acid reflux in the esophagus plays an important role in the carcinogenesis of esophageal adenocarcinoma (EAC). The G-protein coupled bile acid receptor (TGR5) has been associated with the development of gastrointestinal cancer. However, little is known regarding the role of TGR5 in esophageal carcinoma and precancerous lesions. We analyzed genomic DNA from 116 EACs for copy number aberrations via Affymetrix SNP6.0 microarrays. The TGR5 gene locus was amplified in 12.7% (14/116) of the EACs. The TGR5 protein expression was also assessed using immunohistochemistry from tissue microarrays, including Barrett's esophagus (BE), low-(LGD) and high-grade dysplasia (HGD), columnar cell metaplasia (CM), squamous epithelium (SE), EAC and squamous cell carcinoma...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28223090/roux-en-y-gastric-bypass-for-the-treatment-of-severe-complications-after-omega-loop-gastric-bypass
#17
Tigran Poghosyan, Clementine Caille, David Moszkowicz, Mouna Hanachi, Claire Carette, Jean-Luc Bouillot
BACKGROUND: Omega-loop gastric bypass (OLGB) may be associated with severe complications, including anastomotic leak, refractory ulcer or stenosis, undernutrition, and disabling digestive disorders (chronic diarrhea, steatorrhea, bile reflux, and vomiting). OLGB conversion to Roux-en-Y gastric bypass (RYGB) was suggested to treat these complications. OBJECTIVES: To evaluate the efficacy and risk of severe complications after OLGB conversion to RYGB. SETTING: University hospital...
December 9, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28214959/bile-reflux-scintigraphy-after-mini-gastric-bypass
#18
Tuure Saarinen, Jari Räsänen, Jarmo Salo, Antti Loimaala, Miia Pitkonen, Marja Leivonen, Anne Juuti
BACKGROUND: Significant weight-loss and diabetes remission have been reported after mini-gastric bypass (MGB). Concern has been raised regarding postoperative bile reflux (BR), but it has not been demonstrated in previous studies. We set out to find out if BR is evident in hepatobiliary scintigraphy after MGB. METHODS: Nine consecutive patients, seven with type 2 diabetes, underwent MGB (15 cm gastric tube, 250-275 cm biliary limb) at our institution with a 12-month follow-up, with none lost to follow-up...
February 18, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28205007/long-term-evaluation-of-biliary-reflux-after-experimental-one-anastomosis-gastric-bypass-in-rats
#19
Matthieu Bruzzi, Henri Duboc, Caroline Gronnier, Dominique Rainteau, Anne Couvelard, Maude Le Gall, André Bado, Jean-Marc Chevallier
BACKGROUND: Controversy remains regarding biliary reflux after one-anastomosis gastric bypass (OAGB). The aim of this "pilot" study was to analyze biliary reflux and its potential long-term consequences on esogastric mucosae in OAGB-operated rats. METHODS: Diet-induced obese rats were subjected to OAGB (n = 10) or sham (n = 4) surgery and followed up for 16 weeks. Evolution of weight and glucose tolerance was analyzed. Bile acid concentration measurement, histological and qRT-PCR analysis were performed in the esogastric segments...
February 15, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28189119/roux-en-y-duodenojejunostomy-for-surgical-management-of-isolated-duodenal-obstruction-due-to-chronic-pancreatitis
#20
Himanshu Sharma, Sanjay Marwah, Priyanka Singla, Amit Garg, Bittu Bhukkal
INTRODUCTION: Duodenal obstruction in case of chronic pancreatitis is a very rare occurrence and usually presents with gastric outlet obstruction. These cases sometimes require surgical intervention when conservative treatment fails. Gastrojejunostomy and vagotomy has conventionally been performed for management of these cases. PRESENTATION OF CASE: In this report, we present two cases of isolated duodenal obstruction due to chronic pancreatitis that were managed with Roux-en-Y duodenojejunostomy...
2017: International Journal of Surgery Case Reports
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