• 제목/요약/키워드: Gastroenterology

검색결과 1,879건 처리시간 0.049초

Role of Endoscopic Ultrasound in Evaluation of Pancreatic Neuroendocrine Tumors - Report of 22 Cases from a Tertiary Center in Iran

  • Haghighi, Shirin;Molaei, Mahsa;Foroughi, Forough;Foroutan, Mojgan;Dabiri, Reza;Habibi, Effat;Alizadeh, Amir Houshang Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권9호
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    • pp.4537-4540
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    • 2012
  • Background: The pancreatic neuroendocrine tumor (pNET) is relatively rare and generally felt to follow an indolent course. EUS has an important role in detection of pNET. This is a review of clinical and radiological presentation and pathologic reports of 22 patients with pNET. Patients and methods: In this study we analyzed clinical and radiological presentations and pathologic reports of all relevant cases who were referred to Taleghani hospital for 3 years since 2008. Results: A total of 22 patients 28-74 years old (mean=49) were enrolled between 2008 and 2011. Among the total, 13 (59%) were male, 9 (41%) were female and 16 (72.7%) had functional tumors. The results of CT were negative in 12 (54%) cases but EUS was capable of detecting the lesions in these patients, cysts being found in 4 (19%) patients. Conclusion: EUS is a highly sensitive procedure for the localization of functional pNETs and especially insulinomas. Nonfunctional tumors were detected in more advanced and late stages and cystic lesions were more common in this group.

Gender Differences in Paediatric Patients of the Swiss Inflammatory Bowel Disease Cohort Study

  • Herzog, Denise;Buehr, Patrick;Koller, Rebekka;Rueger, Vanessa;Heyland, Klaas;Nydegger, Andreas;Spalinger, Johannes;Schibli, Susanne;Braegger, Christian P.;The Swiss IBD Cohort Study Group
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제17권3호
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    • pp.147-154
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    • 2014
  • Purpose: Gender differences in paediatric patients with inflammatory bowel disease (IBD) are frequently reported as a secondary outcome and the results are divergent. To assess gender differences by analysing data collected within the Swiss IBD cohort study database since 2008, related to children with IBD, using the Montreal classification for a systematic approach. Methods: Data on gender, age, anthropometrics, disease location at diagnosis, disease behaviour, and therapy of 196 patients, 105 with Crohn's disease (CD) and 91 with ulcerative or indeterminate colitis (UC/IC) were retrieved and analysed. Results: The crude gender ratio (male : female) of patients with CD diagnosed at <10 years of age was 2.57, the adjusted ratio was 2.42, and in patients with UC/IC it was 0.68 and 0.64 respectively. The non-adjusted gender ratio of patients diagnosed at ${\geq}10$ years was 1.58 for CD and 0.88 for UC/IC. Boys with UC/IC diagnosed <10 years of age had a longer diagnostic delay, and in girls diagnosed with UC/IC >10 years a more important use of azathioprine was observed. No other gender difference was found after analysis of age, disease location and behaviour at diagnosis, duration of disease, familial occurrence of IBD, prevalence of extra-intestinal manifestations, complications, and requirement for surgery. Conclusion: CD in children <10 years affects predominantly boys with a sex ratio of 2.57; the impact of sex-hormones on the development of CD in pre-pubertal male patients should be investigated.

A Comparative Study Between Cytomegalovirus Immunoglobulin M-Positive and CMV Immunoglobulin M-Negative Biliary Atresia in Infants Attending a Tertiary Care Hospital in Bangladesh

  • Akter, Sharmin;Karim, ASM Bazlul;Mazumder, Md Wahiduzzaman;Rukunuzzaman, Md;Nahid, Khan Lamia;Dey, Bishnu Pada;Sayeed, Maimuna;Rahman, AZM Raihanur;Fathema, Kaniz;Khadga, Mukesh
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제25권5호
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    • pp.413-421
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    • 2022
  • Purpose: Perinatal cytomegalovirus (CMV) infection can lead to biliary atresia (BA) in different entities. This study aimed to compare the clinical, hematological, biochemical, and histological features of infants with BA based on their CMV immunoglobulin M (IgM) status at presentation. Methods: This cross-sectional descriptive study was carried out between January 2019 and June 2020 at the Department of Pediatric Gastroenterology and Nutrition at the Bangabandhu Sheikh Mujib Medical University (BSMMU) in Dhaka. Forty-three patients with BA were selected purposively and categorized into either the CMV IgM-positive or CMV IgM-negative BA group. Categorical variables were compared using Fisher's exact test and chi-square tests, while the Student's t-test and Mann-Whitney U-test were used to compare continuous variables. For all statistical tests, a p-value <0.05 was considered statistically significant. Results: Thirty-three (76.7%) of the cases were between 2 and 3 months of age on admission. The clinical, hematological, and biochemical parameters did not differ significantly between the CMV IgM-positive and CMV IgM-negative BA groups. Most (50.0%) of the CMV IgM-positive cases had fibrosis stage F2, while 43.5% of the CMV IgM-negative cases had fibrosis stage F3, with no significant difference between the groups (p=0.391). Conclusion: Our data shows no significant distinction between CMV IgM-positive and CMV IgM-negative BA, suggesting that CMV does not contribute to BA pathogenesis.

Significance of rescue hybrid endoscopic submucosal dissection in difficult colorectal cases

  • Hayato Yamaguchi;Masakatsu Fukuzawa;Takashi Kawai;Takahiro Muramatsu;Taisuke Matsumoto;Kumiko Uchida;Yohei Koyama;Akir Madarame;Takashi Morise;Shin Kono;Sakik Naito;Naoyoshi Nagata;Mitsushige Sugimoto;Takao Itoi
    • Clinical Endoscopy
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    • 제56권6호
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    • pp.778-789
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    • 2023
  • Background/Aims: Hybrid endoscopic submucosal dissection (ESD), in which an incision is made around a lesion and snaring is performed after submucosal dissection, has some advantages in colorectal surgery, including shorter procedure time and preventing perforation. However, its value for rescue resection in difficult colorectal ESD cases remains unclear. This study evaluated the utility of rescue hybrid ESD (RH-ESD). Methods: We divided 364 colorectal ESD procedures into the conventional ESD group (C-ESD, n=260), scheduled hybrid ESD group (SH-ESD, n=69), and RH-ESD group (n=35) and compared their clinical outcomes. Results: Resection time was significantly shorter in the following order: RH-ESD (149 [90-197] minutes) >C-ESD (90 [60-140] minutes) >SH-ESD (52 [29-80] minutes). The en bloc resection rate increased significantly in the following order: RH-ESD (48.6%), SH-ESD (78.3%), and C-ESD (97.7%). An analysis of factors related to piecemeal resection of RH-ESD revealed that the submucosal dissection rate was significantly lower in the piecemeal resection group (25% [20%-30%]) than in the en bloc resection group (40% [20%-60%]). Conclusions: RH-ESD was ineffective in terms of curative resection because of the low en bloc resection rate, but was useful for avoiding surgery.

Portal cavernography during endoscopic retrograde cholangiopancreatography: from bilhemia to hemobilia

  • Rawad A. Yared;Paraskevas Gkolfakis;Arnaud Lemmers;Vincent Huberty;Thierry Degrez;Jacques Deviere;Daniel Blero
    • Clinical Endoscopy
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    • 제56권4호
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    • pp.521-526
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    • 2023
  • Portobiliary fistulas are rare but may lead to life-threatening complications. Biliary plastic stent-induced portobiliary fistulas during endoscopic retrograde cholangiopancreatography have been described. Herein, we present a case of portal cavernography and recurrent hemobilia after endoscopic retrograde cholangiopancreatography in which a portobiliary fistula was detected in a patient with portal biliopathy. This likely indicates a change in clinical presentation (from bilhemia to hemobilia) after biliary drainage that was successfully treated by placement of a fully covered, self-expandable metallic stent.

Complete Remission of Unresectable Esophageal Cancer Achieved with Concurrent Chemoradiotherapy: A Case Report

  • Jung Min Lee;Bora Keum;Sang Yup Lee;In Kyung Yoo;Seung Han Kim;Hyuk Soon Choi;Eun Sun Kim;Hoon Jai Chun
    • Journal of Digestive Cancer Research
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    • 제5권1호
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    • pp.70-72
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    • 2017
  • A 41-year old woman with dysphagia visited, which was aggravated after eating. On physical examination, there was a palpable mass on the left supraclavicular area. Endoscopic examination revealed a mass on the distal esophagus with irregular mucosa, erythema and a whitish plaque with luminal narrowing. The patient was diagnosed with unresectable esophageal cancer (squamous cell carcinoma, T3N2M1, Stage IV). The patient received CCRT (total 63 Gy) with cisplatin and 5-fluorouracil (5-FU). After CCRT, the patient took an additionally 2 cycles of chemotherapy for consolidation (cisplatin and 5-FU every 4 weeks). After additional chemotherapy, endoscopic examination showed no residual tumor, a chest CT scan revealed that the mass in the distal esophagus had decreased and there was no enlargement of the lymph nodes around the left supraclavicular area. The patient has been in complete remission for 5 years.

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Chylomicron Retention Disease: a Description of a New Mutation in a Very Rare Disease

  • Ferreira, Helena;Ramos, Raquel Nunez;Quan, Cinthia Flores;Ferreiro, Susana Redecillas;Ruiz, Vanessa Cabello;Goni, Javi Juamperez;Bernabeu, Jesus Quintero;Canton, Oscar Segarra;Beltran, Marina Alvarez
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권2호
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    • pp.134-140
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    • 2018
  • Chylomicron retention disease, also known as Anderson's disease, is a rare hereditary hypocholesterolemic disorder, recessive inherited, characterized by nonspecific symptoms as abdominal distension, steatorrhea, and vomiting associated with failure to thrive. We describe a patient with failure to thrive, chronic diarrhea and steatorrhea who the diagnosis of chylomicron retention disease was established after several months of disease progression. The genetic study confirmed a homozygosity mutation in SAR1B gene, identifying a mutation never previous described [c.83_84delTG(p.Leu28Argfs*7)]. With this case report the authors aim to highlight for this very rare cause of failure to thrive and for the importance of an attempting diagnosis, in order to start adequate management with low fat diet supplemented with fat-soluble vitamins, reverting the state of malnutrition and avoiding possible irreversible and desvantating complications.

Accuracy of the 2008 Simplified Criteria for the Diagnosis of Autoimmune Hepatitis in Children

  • Arcos-Machancoses, Jose Vicente;Busoms, Cristina Molera;Tatis, Ecaterina Julio;Bovo, Maria Victoria;Bernabeu, Jesus Quintero;Goni, Javier Juamperez;Martinez, Vanessa Crujeiras;Martin de Carpi, Javier
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권2호
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    • pp.118-126
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    • 2018
  • Purpose: Classical criteria for diagnosis of autoimmune hepatitis (AIH) are intended as research tool and are difficult to apply at patient's bedside. We aimed to study the accuracy of simplified criteria and the concordance with the expert diagnosis based on the original criteria. Methods: A cohort of children under study for liver disorder was selected through consecutive sampling to obtain the prevalence of AIH within the group of differential diagnoses. AIH was defined, based on classical criteria, through committee review of medical reports. Validity indicators of the simplified criteria were obtained in an intention to diagnose approach. Optimal cut-off and the area under the receiver operating characteristic (ROC) curve were calculated. Results: Out of 212 cases reviewed, 47.2% were AIH. For the optimal cut-off (6 points), the simplified criteria showed a sensitivity of 72.0% and a specificity of 96.4%, with a 94.7% positive and a 79.4% negative predictive value. The area under the ROC curve was 94.3%. There was a good agreement in the pre-treatment concordance between the classical and the simplified criteria (kappa index, 0.775). Conclusion: Simplified criteria provide a moderate sensitivity for the diagnosis of AIH, but may help in indicating treatment in cases under suspicion with 6 or more points.