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Articles 1 - 20 of 20
Full-Text Articles in Gastroenterology
Rumination Syndrome Diagnosis Supported By Colon Manometry In A Pediatric Patient, Alex Biller, John Rosen, Amornluck Krasaelap
Rumination Syndrome Diagnosis Supported By Colon Manometry In A Pediatric Patient, Alex Biller, John Rosen, Amornluck Krasaelap
Posters
Introduction: Rumination syndrome is a disorder of gut-brain interaction characterized by effortless repetitive postprandial regurgitation, reswallowing, and/or spitting.(1) This condition is caused by increased intragastric pressure due to abdominal muscle contractions, leading to the opening of the lower esophageal sphincter and the return of gastric content into the esophagus.(1) Rumination is a clinical diagnosis after the exclusion of other etiologies of symptoms. The diagnosis of rumination is clinical, but supportive evidence can be obtained through esophageal or antroduodenal manometry.(2) We present a unique case report of rumination syndrome diagnosis supported by data obtained during colon manometry in a pediatric patient. …
Sangrado Del Tubo Digestivo Alto Secundario A Infección De Adenovirus, Moises Alatorre-Jimenez, Sarah T. Edwards, Thomas M. Attard
Sangrado Del Tubo Digestivo Alto Secundario A Infección De Adenovirus, Moises Alatorre-Jimenez, Sarah T. Edwards, Thomas M. Attard
Posters
Titulo: Sangrado del Tubo Digestivo Alto Secundario a Infección de Adenovirus Introducción: El Sangrado del tubo digestivo alto (STDA) es causado por múltiples etiologías incluyendo gastritis, varices, esofagitis, anomalidades vasculares, cuerpos extraños, y ulceras (1). Dentro de estas causas se conoce que infecciones virales pueden producir ulceras causando sangrado los más comunes son el virus de Epstein- Barr, Covid-19, Herpesvirus-6, Herpesvirus-7 y Citomegalovirus (1,2,3,4,5). Presentamos el caso de un paciente con STDA severo a causa de infección por adenovirus. Reporte de Caso: Paciente de 22 meses de edad, previamente sano que se presenta al servicio de Urgencias debido a un …
Latency Time From Prior Authorization Submission To Initiation Of Biologic Therapy In Inflammatory Bowel Disease, Shannon Capraro, Janelle R. Noel-Macdonnell Phd, Lauren Disselhoff, Layne Sieve, Rachel Chevalier
Latency Time From Prior Authorization Submission To Initiation Of Biologic Therapy In Inflammatory Bowel Disease, Shannon Capraro, Janelle R. Noel-Macdonnell Phd, Lauren Disselhoff, Layne Sieve, Rachel Chevalier
Posters
Background For pediatric patients with a diagnosis of inflammatory bowel disease (IBD), initiation of biologic therapy can be essential to attain disease control. Unfortunately, patients often experience delays in receiving the first dose of these medications due to the need for insurance companies to approve medication prior authorizations (PA). Physicians and support staff spend many working hours collating and transferring information regarding urgency to payors. To our knowledge, no studies exist to evaluate the factors that contribute to how quickly a medication is approved in pediatric patients. We set out here to evaluate which demographic and disease factors contribute to …
Drug Metabolizing Enzymes And Transporters May Help Determine Effective Budesonide Dosing In Eoe, Laurie Mccann, Lisa Harvey, Norah Almahbub, Wendy Y. Wang, Erin C. Boone, Janelle R. Noel-Macdonnell, Rachel Chevalier
Drug Metabolizing Enzymes And Transporters May Help Determine Effective Budesonide Dosing In Eoe, Laurie Mccann, Lisa Harvey, Norah Almahbub, Wendy Y. Wang, Erin C. Boone, Janelle R. Noel-Macdonnell, Rachel Chevalier
Posters
Background: Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder diagnosed in children with painful or difficult swallowing, vomiting, or poor weight gain. Current treatment models adopt a trial-and-error approach in regard EoE treatment, including restrictive elimination diets, proton pump inhibitors, and topical budesonide. This approach can delay effective treatment which increases risk of disease progression and increases medical costs to families for frequent clinic visits and endoscopy. Objectives/Goal: The objective of this study is to determine the CYP3A5 genotype and expression of patients with eosinophilic esophagitis to discover which patients will respond to standard dosing of topical budesonide treatment (1, …
A Metabolic, Mechanical, Multi-Organ Masterpiece: Dural Device Support Bridge To En-Bloc Heart-Liver Transplantation In Propionic Acidemia, Rebecca Juhl, Brian Birnbaum, Aliessa P. Barnes, William Gibson, Bhargava Mullapudi, Beth Lang, Megan Faseler, Daniel E. Heble, Victoria Urban, Ryan T. Fischer, Jennifer L. Gannon, David Sutcliffe
A Metabolic, Mechanical, Multi-Organ Masterpiece: Dural Device Support Bridge To En-Bloc Heart-Liver Transplantation In Propionic Acidemia, Rebecca Juhl, Brian Birnbaum, Aliessa P. Barnes, William Gibson, Bhargava Mullapudi, Beth Lang, Megan Faseler, Daniel E. Heble, Victoria Urban, Ryan T. Fischer, Jennifer L. Gannon, David Sutcliffe
Posters
Introduction: Propionic Acidemia (PA) is a disorder related to abnormal protein and lipid metabolism resulting in progressive neurological injury and dilated cardiomyopathy (DCM). Interventions for PA and secondary disease manifestations can require multi-organ transplantation. Herein we report the case of a child with PA and end-stage DCM requiring left ventricular assist device (LVAD) support with eventual heart-liver transplant. Case Report: A 17 year old male diagnosed in childhood with PA developed chronically progressive DCM culminating in end stage heart failure with acute decompensations. In a recurrent admission, he progressed to require dual inotropic support and systemic anticoagulation for new LV …
Two Siblings With Microvillous Inclusion Disease, Moises Alatorre-Jimenez, Brandi Weller, Meike Orlick, William San Pablo
Two Siblings With Microvillous Inclusion Disease, Moises Alatorre-Jimenez, Brandi Weller, Meike Orlick, William San Pablo
Posters
Introduction: Microvillous Inclusion Disease (MVID) (OMIM#251850) is a rare autosomal recessive condition caused by mutations or deletions mostly in the MYH6 gene but also STX3 and STXBP2 genes. It is characterized by protracted diarrhea with severe congenital alteration of the intestinal epithelium resulting in watery diarrhea, metabolic acidosis, failure to thrive, and permanent malabsorption that normally leads to a lifelong dependency on total parenteral nutrition (TPN) and the eventual possibility of bowel transplantation . Histological hallmarks of MVID in small intestinal biopsies are hypoplastic, atrophic, or disorganized villi without crypt hypertrophy, or immune cell infiltrate and, at the intestinal cellular …
Intraductal Papillary Mucinous Neoplasm In An 18-Year-Old With Recurrent Pancreatitis, Nadia Ibrahimi, Thomas M. Attard, Moises Alatorre-Jimenez, Karie Robinson, Syed Jafri
Intraductal Papillary Mucinous Neoplasm In An 18-Year-Old With Recurrent Pancreatitis, Nadia Ibrahimi, Thomas M. Attard, Moises Alatorre-Jimenez, Karie Robinson, Syed Jafri
Posters
Introduction: Intraductal Papillary Mucinous Neoplasms (IPMNs) of the pancreas are premalignant, intraductal, mucin secreting cystic lesions. IPMNs are a rare entity in the pediatric population and commonly seen in men in their 6 to 7 decade. Pediatric IPMN has been previously reported in a 14-year-old and a neonate, who also had hyperinsulinism and a de novo germline SKIL gene mutation. . Kim et al. did a ten-year single centered pediatric pancreatic malignancy study discovering IPMN in one patient of 35 with pancreatic mass removals . Case: Our patient is an 18-year-old male who initially presented at the age of 15 …
Endoscopic Retrograde Cholangiography Using A Colonoscope In A Pediatric Liver Transplant Patient With Roux-En-Y Biliary Anastomosis, Nadia Ibrahimi, Thomas M. Attard, Ryan T. Fischer, Voytek Slowik, Richard J. Hendrickson, Bhargava Mullapudi, Moises Alatorre-Jimenez, Syed Jafri
Endoscopic Retrograde Cholangiography Using A Colonoscope In A Pediatric Liver Transplant Patient With Roux-En-Y Biliary Anastomosis, Nadia Ibrahimi, Thomas M. Attard, Ryan T. Fischer, Voytek Slowik, Richard J. Hendrickson, Bhargava Mullapudi, Moises Alatorre-Jimenez, Syed Jafri
Posters
Introduction: Biliary ducal sequelae including occlusions, strictures, leaks, or necrosis frequently complicate pediatric liver transplantation. The underlying etiology includes prolonged intraoperative ischemia or postoperative arterial inflow obstruction. In adult patients the role of endoscopic retrograde cholangiography (ERC) is well established in the management of biliary complications post-liver transplantation. In contrast, in the pediatric population, due to the combination of small patient size and the complexity of Roux-en-Y anastomotic techniques, ERC has been described as difficult or virtually impossible. This limits the options available for managing biliary duct complications to percutaneous techniques Endoscopic management of biliary complications in pediatric patients with …
Cap Polyposis: An Unusual Cause Of Rectal Bleeding In A Young Patient, Inayat Gill, Nishant Aggarwal, Mitual Amin, Atulkumar Patel
Cap Polyposis: An Unusual Cause Of Rectal Bleeding In A Young Patient, Inayat Gill, Nishant Aggarwal, Mitual Amin, Atulkumar Patel
Posters
No abstract provided.
Gastrointestinal Kaposi Sarcoma: A Case Report, Samiksha Pandey, Shailesh Niroula, Rabin Neupane, Gaurav Kakked, Naveen Reddy
Gastrointestinal Kaposi Sarcoma: A Case Report, Samiksha Pandey, Shailesh Niroula, Rabin Neupane, Gaurav Kakked, Naveen Reddy
Posters
• Kaposi sarcoma (KS) in the gastrointestinal (GI) tract is an uncommon entity specially without any cutaneous manifestation since the introduction of HAART therapy in HIV patients. • Most of the gastrointestinal KS, remains undiagnosed as majority of KS is asymptomatic.(1) Here we present a case of GI- KS in a HIVAIDS patient.
Endoscopic Management Of Migrated Pancreatic Stent Into Hepaticojejunostomy Causing Acute Pancreatitis, Samiksha Pandey, Andrew Aneese, Shailesh Niroula, Laith H. Jamil
Endoscopic Management Of Migrated Pancreatic Stent Into Hepaticojejunostomy Causing Acute Pancreatitis, Samiksha Pandey, Andrew Aneese, Shailesh Niroula, Laith H. Jamil
Posters
• Trans-anastomotic pancreatic stents after the pancreatoduodenectomy are placed to decrease the complications, maintain ductal patency and support healing of the anastomosis. • Complications of migration of trans-anastomotic stent from the pancreatojejunostomy (PJ) through the hepaticojejunostomy (HJ) is rare. • We present a case of acute pancreatitis in the setting of pancreatic duct (PD) stent migration into the biliary tree in a patient who had previously undergone pancreaticoduodenectomy.
Risk Factors Of Clostridium Difficile Infection In Helicobacter Pylori Diagnosed Patients: A Multicenter Study, Samiksha Pandey, Tamera Tennant, Ashbina Pokharel, Andrew Aneese, Alexandra Halalau
Risk Factors Of Clostridium Difficile Infection In Helicobacter Pylori Diagnosed Patients: A Multicenter Study, Samiksha Pandey, Tamera Tennant, Ashbina Pokharel, Andrew Aneese, Alexandra Halalau
Posters
• Clostridium difficile infection (CDI) is one of the most common gastrointestinal illnesses. • There are conflicting studies regarding the association of CDI with Helicobacter Pylori (H. pylori) treatment regimens.1-3 • Our aim is to investigate the risk of CDI in those treated for H. pylori as well as characterize other risk factors for developing CDI.
Colonoscopy-Induced Transient Mobitz Type 1 Block, Inayat Gill, Samiksha Pandey, Atulkumar Patel
Colonoscopy-Induced Transient Mobitz Type 1 Block, Inayat Gill, Samiksha Pandey, Atulkumar Patel
Posters
• Propofol is a commonly used anesthetic in endoscopic procedures. • It can prolong the AV conduction through vagal stimulation leading to AV block. • We report a unique case of a healthy female undergoing a routine screening colonoscopy who developed a Mobitz type I block, in which propofol was the sole agent used for sedation.
Inverted Appendix Presenting As Abdominal Pain And Lower Gastrointestinal Bleeding, Moises Alatorre-Jimenez, Thomas M. Attard
Inverted Appendix Presenting As Abdominal Pain And Lower Gastrointestinal Bleeding, Moises Alatorre-Jimenez, Thomas M. Attard
Posters
Background: Cecal polyps are challenging insofar as the region represents the highest risk of bleeding and perforation during polypectomy . In addition, polypoid lesions in the cecum may represent a morphologically abnormal ileocecal valve or an inverted appendix. Inadvertent polypectomy in those scenarios would lead to serious sequelae including perforation. Case report: Our patient is a 6-year-old male with a background history of prematurity, lactose intolerance, chronic esophagitis, gastritis, constipation, and painless rectal bleeding. He presented with a acute onset diffuse, severe abdominal pain associated with diarrhea that evolved to include hematochezia. At the time of presentation, he required aggressive …
Endoscopic Removal Of Safety Pin From Appendiceal Orifice, Alex Biller, Moises Alatorre-Jimenez, Jeremy Stewart, Ruba A. Abdelhadi
Endoscopic Removal Of Safety Pin From Appendiceal Orifice, Alex Biller, Moises Alatorre-Jimenez, Jeremy Stewart, Ruba A. Abdelhadi
Posters
Introduction: Foreign body ingestion in children is considered a common concern in every Emergency Department worldwide. In the United States, it is estimated that foreign body ingestions cause approximately 1,500 deaths yearly (1). Safety pins ingestions are estimated to be 1% of the foreign body ingestions in children (2). In literature, ingested safety pins have been reported to be lodged mostly in the upper gastrointestinal tract, but a few cases have been reported to be lodged in the appendix (2,3,4). Objective: Recommendations for safety pin ingestions when past the second portion of the duodenum. Case: We report the case of …
Caregiver Mental Health Screening In A Pediatric Feeding Clinic, Dana Bakula, Laura Slosky, Kelsey Dean, Ann M. Davis, Sarah T. Edwards
Caregiver Mental Health Screening In A Pediatric Feeding Clinic, Dana Bakula, Laura Slosky, Kelsey Dean, Ann M. Davis, Sarah T. Edwards
Posters
Introduction: One in four adults have mental health (MH) problems. Caregivers of children with feeding problems are at even higher risk for mental health (MH) problems, including depression, anxiety, and posttraumatic stress. Caregiver MH concerns have a negative impact on caregiver and child quality of life and are specifically linked to suboptimal child feeding practices. Thus, it is critical to identify caregiver MH problems in pediatric feeding settings. However, it can be challenging to comprehensively screen for caregiver MH in a busy pediatric feeding clinic. This emphasizes the importance of a feasible and brief method for screening caregiver MH. Methods: …
Standardizing Resident Education On Gi Service, Jennifer Halma, Kenneth Schmidt
Standardizing Resident Education On Gi Service, Jennifer Halma, Kenneth Schmidt
Posters
Introduction: The pediatric residency curriculum at Children’s Mercy Hospital is standardized to offer each trainee the same rotational experience. As a result, each resident spends one month on the inpatient gastroenterology (GI) service during training. This invites variability in the quantity and quality of GI education that residents receive. Therefore, there is a need to design a standard curriculum to provide comprehensive GI education. The aim of this project is to standardize resident education by identifying most requested topics and providing didactic education to increase resident general GI knowledge. Methods: Each month, residents were provided with a survey to assess …
Elevated Stool Inflammatory Markers In Early Onset Polymorphic Post-Transplant Lymphoproliferative Disease Following Orthotopic Heart Transplant, Jeremy Stewart, Keith August, Thomas M. Attard
Elevated Stool Inflammatory Markers In Early Onset Polymorphic Post-Transplant Lymphoproliferative Disease Following Orthotopic Heart Transplant, Jeremy Stewart, Keith August, Thomas M. Attard
Posters
Acute gastrointestinal hemorrhage in the context of a recent organ transplant with immunosuppression, antibiotic exposure, drug exposures and other comorbidities is a challenging clinical scenario with coordinated multidisciplinary effort needed to optimize management and outcomes. We present a patient with recent solid organ transplant with severe acute gastrointestinal bleeding attributable to EBV associated post-transplant lymphoproliferative disease. The patient is a 13-year-old Female with Williams syndrome who is EBV negative and CMV positive who received an EBV/CMV positive orthotopic heart transplant 5.5 months prior to presentation. She presented with bloody diarrhea, anemia (7.8 gm/dL), hypovolemia, and acute kidney injury (BUN 25 …
A Review Of First Year Fellow Endoscopic Skills And Time To Proficiency, Antoinette Adjowa O. Walker, Dalya El Tawil, Jennifer Colombo, Nicholas Clark, Kimberly J. Reid
A Review Of First Year Fellow Endoscopic Skills And Time To Proficiency, Antoinette Adjowa O. Walker, Dalya El Tawil, Jennifer Colombo, Nicholas Clark, Kimberly J. Reid
Posters
Through this quality improvement project, we have assessed the current fellows' upper endoscopy skill level during their first year and determined that the time to achieving proficiency is significantly longer than desired. The goal is to prepare new fellows for endoscopy prior to the beginning of their rotations with a curriculum that includes assigned reading materials, videos, and simulated endoscopic cases, to promote safety and increase satisfaction of patients by improving the readiness, skill level, and the confidence of first year inexperienced fellows.
Pediatric Ppi Use And Fractures, Nathan R. Fleishman, Troy Richardson, Thomas M. Attard
Pediatric Ppi Use And Fractures, Nathan R. Fleishman, Troy Richardson, Thomas M. Attard
Posters
This study compared the rate of fracture among pediatric patients exposed to proton pump inhibitors to the rate among patients without exposure, and also considered the fracture location among children exposed to proton pump inhibitors.