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Duodenal ulcer

Jonathan Zagzag, Noah Avram Cohen, George Fielding, John Saunders, Prashant Sinha, Manish Parikh, Paresh Shah, Nicole Hindman, Christine Ren-Fielding
Perforated duodenal ulcer following RYGB is an unusual clinical situation that may be a diagnostic challenge. Only 23 cases have previously been reported. We present five cases. The hallmark of visceral perforation, namely pneumoperitoneum, was not seen in three of the four cases that underwent cross sectional imaging. This is perhaps due to the altered anatomy of the RYGB that excludes air from the duodenum. Our cases had more free fluid than expected. The bariatric surgeon should not wait for free intraperitoneal air to suspect duodenal perforation after RYGB...
July 12, 2018: Obesity Surgery
Martin Stašek, René Aujeský, Radek Vrba, Martin Loveček, Josef Chudáček, Petr Janda, Michal Gregořík, Katherine Vomáčková, Čestmír Neoral, Dušan Klos
Introduction: Intraoperative esophagogastroduodenoscopy (IOG) is a diagnostic and therapeutic method for a variety of special conditions in upper gastrointestinal (UGI) pathology. The indication remains individual due to insufficient evidence and limited training of surgeons in digestive endoscopy. Aim: To evaluate the indications, benefits and risks of IOG. Material and methods: A single-center retrospective study of 110 consecutive IOGs in 104 patients was performed...
June 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Jie Pu, Fen Wang, Wei Tang, Mingshe Zhu
Ilaprazole is a new proton pump inhibitor (PPI) and currently marketed in China and South Korea for the treatment of gastric and duodenal ulcer. Ilaprazole has a favorable long half-life and minimal pharmacokinetic variability associated with CYP2C19 polymorphism. Sulfoxide oxidation of ilaprazole is catalyzed mainly by CYP3A4. Thus, it has been widely accepted that CYP3A4 plays the major role in the clearance of ilaprazole in human. However, ADME data of radiolabeled ilaprazole in human are not available and ilaprazole exposure to human is not elevated by a co-administered potent CYP3A4 inhibitor...
July 12, 2018: Drug Metabolism and Disposition: the Biological Fate of Chemicals
X X Han, D X Guan, J Zhou, F H Yu, G L Wang, T L Mei, S Guo, L B Fu, J Zhang, H Q Shen, X W Xu
Objective: To summarize the clinical data including manifestations, diagnosis, treatment and prognosis of eosinophilic gastroenteritis (EGE) in children. Methods: A retrospective analysis was performed in 71 patients with pathologically proven EGE at Beijing Children's Hospital Affiliated to Capital Medical University from January 2008 to January 2017. Their clinical manifestations, laboratory and imaging examinations, endoscopic findings, histopathological examinations, and treatment were collected and analyzed...
July 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Ahmet Basturk, Reha Artan, Aygen Yılmaz, Mustafa T Gelen
Purpose: The aim of this study is to determine the involvement of the upper gastrointestinal system (GIS) in patients diagnosed with Crohn's disease (CD), ulcerative colitis (UC), and non-inflammatory bowel disease (IBD) and to compare their differences. Methods: This study included patients aged between 2 and 18 years who underwent colonoscopy and esophagogastroduodenoscopy (EGD) for the first time due to the prediagnosis of IBD. In EGD, samples were taken from duodenum, antrum, corpus, and esophagus; and gastritis, duodenitis, and esophagitis were identified through histopathologic examination...
July 2018: Pediatric Gastroenterology, Hepatology & Nutrition
Ravishankar Asokkumar, Roy Soetikno, Andres Sanchez-Yague, Lim Kim Wei, Ennaliza Salazar, Jing Hieng Ngu
Background and study aims : Endoscopic treatment of non-variceal upper gastrointestinal bleeding (NVUGIB) with high-risk adverse outcome (HR-AO) features has a high risk of failure. We studied the safety and efficacy of over-the-scope clips (OTSC) to treat these lesions. Patients and methods : We included patients who were treated using OTSC for NVUGIB from January 2015 to October 2017. We studied rebleeding and mortality rates and used the Rockall data and our institution's prior data for comparison...
July 2018: Endoscopy International Open
Murat Akaydin, Okan Demiray, Ekrem Ferlengez, Fazilet Erozgen, Yeliz E Ersoy, Muzaffer Er
Choledochoduodenal fistula (CDF) is an abnormal passage between the choledochus and duodenum. The most common causes of CDF are cholelithiasis, duodenal ulcer, and tumors. There are mainly two types of fistulas depending on the location. Type 1 is usually present on the longitudinal fold just close to the papilla. Type 2 is present at the duodenal mucosa adjacent to the longitudinal fold and probably caused by larger stones, duodenal ulcer penetration, impacted cystic duct stones, and as a complication of laparoscopic cholecystectomy...
June 2018: Indian Journal of Surgery
Chuang He, Yun Liu, Yang Li, Li Yang, Yuan-Ting Li, Shan-Liang Li, Xue-Quan Huang
Purpose: A survival benefit may be associated with the positive control of extrahepatic lymph node metastasis (LNM) of hepatocellular carcinoma (HCC). However, no standard treatment exists. The aim of this study was to evaluate the safety and efficacy of iodine-125 (125 I) brachytherapy (BT) of LNM of HCC, especially in patients with multiple lymph nodules or repeated lymph node recurrence. Materials and Methods: From June 2007 to July 2016, clinical and imaging data of 22 patients were collected at our center...
2018: Journal of Cancer Research and Therapeutics
Teppei Yamaguchi, Yusuke Gotoh, Hidekazu Hattori, Hidetoshi Katsuno, Kazuyoshi Imaizumi
A previous randomized phase II study in patients with non-small cell lung cancer (NSCLC) identified that combination treatment with erlotinib plus bevacizumab prolonged progression-free survival compared with erlotinib alone. However, combination bevacizumab and erlotinib treatment generally increased the risk of severe adverse events, including hemorrhage, thrombosis, fistula formation and gastrointestinal perforation. The present report describes two patients with NSCLC harboring epidermal growth factor receptor (EGFR) mutations, who experienced gastrointestinal perforation associated with erlotinib plus bevacizumab combination therapy...
July 2018: Oncology Letters
Peter S Potrebko, Ravi Shridhar, Matthew C Biagioli, William F Sensakovic, George Andl, Jan Poleszczuk, Timothy H Fox
This work demonstrates the efficacy of voxel-based 90 Y microsphere dosimetry utilizing post-therapy SPECT/CT imaging and applies it to the prediction of treatment response for the management of patients with hepatocellular carcinoma (HCC). A 90 Y microsphere dosimetry navigator (RapidSphere) within a commercial platform (Velocity, Varian Medical Systems) was demonstrated for three microsphere cases that were imaged using optimized bremsstrahlung SPECT/CT. For each case, the 90 Y SPECT/CT was registered to follow-up diagnostic MR/CT using deformable image registration...
July 1, 2018: Journal of Applied Clinical Medical Physics
Paolo Cerrone, Michele Marchese, Maria Antonietta Pistoia, Carmine Marini
Continuous duodenal infusion of levodopa/carbidopa intestinal gel (LCIG) is an established treatment to control motor fluctuations in Parkinson's disease. Duodenal infusion allows a steady absorption of the drug in the small bowel, reducing plasmatic fluctuations of levodopa. Some complications may occur during the treatment, often related to intrajejunal percutaneous endoscopic gastrostomy (PEG-J). We report a case of duodenal ulcer associated with a phytobezoar involving the end of jejunal probe, in a patient who underwent PEG-J for LCIG infusion...
June 29, 2018: BMJ Case Reports
Koji Takeuchi, Kikuko Amagase
Endogenous prostaglandins (PGs), produced from arachidonic acid by the two isoforms of cyclooxygenase (COX), play a pivotal role in maintaining mucosal integrity by modulating various functions of the gastrointestinal (GI) tract, and PGE2 is most effective in these actions. The PGE2 receptor is classified into 4 specific G-protein coupled subtypes, EP1-EP4, and their distribution accounts for the multiple effects of this prostanoid. PGE2 prevents acid-reflux esophagitis and indomethacin-induced gastric lesions through EP1 receptors, while endogenous PGs protect the stomach against cold restraint stress mediated by mainly PGI2/IP receptors and partly EP4 receptors...
June 28, 2018: Current Pharmaceutical Design
A I Khripun, I V Sazhin, S N Shurygin, G B Makhuova
AIM: To analyze the outcomes of fast track rehabilitation program in patients with perforated duodenal ulcer (PDU). MATERIAL AND METHODS: For the period 2013-2016 at the Department of Surgery and Endoscopy 206 PDU patients have been treated. Inclusion criterion for the main group (n=77) was duodenal ulcers, their dimension up to 1 cm, laparoscopic suture of perforated ulcer, fast track rehabilitation program implementation. The control group consisted of 129 patients who underwent open suturing of perforated ulcer followed by conventional treatment in postoperative period...
2018: Khirurgiia
Natalia P Denisenko, Dmitriy A Sychev, Zhanna M Sizova, Valeriy V Smirnov, Kristina A Ryzhikova, Zhannet A Sozaeva, Elena A Grishina
Background: Proton pump inhibitors (PPIs) are metabolized by cytochrome P450. CYP2C19 is the main isoenzyme for the majority of PPI, whereas CYP3A family is a secondary enzyme for PPI biotransformation. Purpose: The aim of the study was to find if CYP3A4*22, CYP3A5*3, CYP2C19*2, CYP2C19*3 , and CYP2C19*17 genotypes are connected with CYP3A and CYP2C19 activities in Russian peptic ulcer patients taking omeprazole. Patients and methods: Forty-eight gastric or duodenal ulcer patients (15 men, 33 women; mean age 55...
2018: Pharmacogenomics and Personalized Medicine
Yoshiro Hadano, Yusuke Kinugasa, Kiyofumi Ohkusu, Kazushige Ishibashi, Miwako Isoda
We describe a case of Gemella haemolysans septic shock in a 75-year old Japanese male with a duodenal perforation and secondary peritonitis. Blood cultures on admission were positive for Gram-positive and Gram-variable cocci, and G. haemolysans was identified using whole cell matrix-assisted laser desorpition/ionization mass spectrometry (MALDI-TOF MS), with a score value of 2.12. The 16S rRNA sequencing was difficult to use as a diagnostic test because there was more than 99% sequence homology with related bacterial strains...
2018: IDCases
Cosmin Caraşca, George Simion, Adela Corina Nechifor-Boilă, Alina Mioara Boeriu, Ecaterina Daniela Dobru
Primary duodenal cancer is a rare entity accounting for only 0.3% of all gastrointestinal cancers. Histopathologically, most duodenal cancers are mucin-producing adenocarcinomas, 34% being poorly differentiated. Signet-ring cell (SRC) carcinoma is extremely uncommon in the duodenum. Herein, we report a rare case of SRC carcinoma associated with poorly differentiated adenocarcinoma of the non-ampullary duodenum in a 74-year-old woman. The patient was admitted to the hospital for persistent epigastric pain, significant weight loss and hypochromic microcytic anemia...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Jannis Kountouras, Stergios A Polyzos, Michael Doulberis, Christos Zeglinas, Fotini Artemaki, Elizabeth Vardaka, Georgia Deretzi, Evaggelia Giartza-Taxidou, Dimitri Tzivras, Efthymia Vlachaki, Evangelos Kazakos, Panagiotis Katsinelos, Christos S Mantzoros
Both Helicobacter pylori infection and metabolic syndrome present significant global public health burdens. Metabolic syndrome is closely related to insulin resistance, the major underlying mechanism responsible for metabolic abnormalities, and Helicobacter pylori infection has been proposed to be a contributing factor. There is growing evidence for a potential association between Helicobacter pylori infection and insulin resistance, metabolic syndrome and related morbidity, including abdominal obesity, type 2 diabetes mellitus, dyslipidemia, hypertension, all of which increase mortality related to cardio-cerebrovascular disease, neurodegenerative disorders, nonalcoholic fatty liver disease and malignancies...
June 21, 2018: Metabolism: Clinical and Experimental
Yong Xie, Zhenhua Zhu, Jiangbin Wang, Lingxia Zhang, Zhenyu Zhang, Hong Lu, Zhirong Zeng, Shiyao Chen, Dongsheng Liu, Nonghua Lv
Objectives: To investigate the efficacy and safety of 10-day bismuth quadruple therapy with amoxicillin, tetracycline or clarithromycin and different doses of rabeprazole for first-line treatment of Helicobacter pylori infection. Methods: This multicenter, randomized, parallel-controlled clinical trial was conducted between March 2013 and August 2014. A total of 431 H. pylori -infected patients with duodenal ulcers were enrolled and randomized into four treatment groups (1:1:1:1) for 10 days: 1. LR-BAC Group, which received rabeprazole 10 mg b...
June 18, 2018: Antimicrobial Agents and Chemotherapy
Hassan Salmanroghani, Massoud Mirvakili, Mahmud Baghbanian, Roham Salmanroghani, Golshid Sanati, Pouria Yazdian
AIM: To evaluate the efficacy and tolerability of tetracycline vs. high-dose amoxicillin in bismuth-based quadruple therapy for Helicobacter pylori(H. pylori) eradication. METHODS: This randomized, open-label clinical trial included 228 patients with H.pylori infection and duodenal ulcer without a history of H.pylori treatment. Patients were randomly divided into two groups. The amoxicillin group received metronidazole 500mg, bismuth subcitrate 240mg, and amoxicillin 1000mg, all three times a day, plus omeprazole 20 mg twice a day, for 14 days...
2018: PloS One
Olena M Komar, Nataliya M Kizlova, Oleksandra D Trylevych, Vasyl V Kravchenko
OBJECTIVE: Introduction: High morbidity rate, frequent relapses, and significant economic losses give reasons for highlighting the peptic ulcer disease as the most topical medical-statistical problem. The aim of the study is to assess the influence of the main risk factors on the course of gastric and duodenal peptic ulcer. PATIENTS AND METHODS: Materials and methods: We formed up the risk groups consisted of patients with 12 modified (4) and regular (8) factors, each characterized with its own signs and gradations...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
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