Gastroenterology Commons^™

Obsolete Or Essential? Gastrointestinal Decontamination In Severe Bupropion Ingestions: A Case Series, Alexandra Amaducci Do, Andrew F. Miller Do, Derek J. Fikse Do, Gillian A. Beauchamp Md

Department of Emergency Medicine

No abstract provided.

Oral Budesonide Is An Effective Alternative To Prednisone For Treatment Of Autoimmune Hepatitis, Natanie J. Anilovich

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Manns MP, Woynarowski M, Kreisel W, et al. Budesonide induces remission more effectively than prednisone in a controlled trial of patients with autoimmune hepatitis. Gastroenterology. 2010;139(4):1198-1206. https://doi.org/10.1053/j.gastro.2010.06.046

for a patient with autoimmune hepatitis developing septic arthritis secondary to prednisone therapy.

Klebsiella Pneumoniae Cryptogenic Liver Abscess And Endophthalmitis – A Case Report And Review Of Literature, Mihai Leonard Grecescu, Monica Grecescu, Andreea Smarandache Maria, Cristian Mihai Branescu, Anca Anghelache, Anca Silvia Dumitriu, Stana Paunica, Andreea Cristina Costea

Journal of Mind and Medical Sciences

Klebsiella pneumoniae has emerged as the predominant pathogenic agent of liver abscess in Asia, and the incidence is increasing worldwide. Hypervirulent strains are associated with septic metastatic dissemination in the eyes, lungs, and central nervous system, causing severe morbidity. We present the case of a 54year old man, with no previous comorbidities, admitted in emergency for the blind red painful eye. Further investigation documented septic endophthalmitis with transscleral extension and orbital cellulitis. Thoraco-abdominal computed tomography evidenced a hepatic abscess as the locus of the primary infection. Intravenous antibiotherapy with cefuroxime, followed by meropenem and vancomycin were efficient for managing the …

A Rare Complication In A Covid-19 Positive Patient With Sigmoid Colon Cancer-Hemoperitoneum Due To Gallbladder Necrosis Following Micro-Thrombosis, Mihai Faur, Andrei Moisin, Calin Mohor, Dan Sabau

Journal of Mind and Medical Sciences

Covid-19, also known as acute respiratory syndrome 2019-nCoV, severe acute respiratory syndrome (SARS) 2, and Wuhan pneumonia, is a viral respiratory disease caused by a SARS-associated coronavirus (SARS-CoV-2). The most serious complications of Covid-19 are due to the development of micro-thrombosis in various organs and systems as a result of the high levels of pro-inflammatory cytokines (tumor necrosis factor alpha, interleukin 1 and 6) which initiate the activation of coagulation and the generation of thrombin. Several studies demonstrated the poor outcome of Covid-19-infected patients who underwent surgery, suggesting that surgery may accelerate and exacerbate Covid-19 progression. We report the case …

Quality Of Life And Special Issues In Women With Inflammatory Bowel Diseases, Gabriel Constantinescu, Gina Gheorghe, Ecaterina Rinja, Oana Plotogea, Vasile Sandru, Andreea Butuc, Camelia Cristina Diaconu, Anca Macovei Oprescu, Bogdan Popa, Madalina Ilie

Journal of Mind and Medical Sciences

Introduction. The impact of inflammatory bowel diseases (IBD) on the quality of life (QoL) of patients is significant and it has important social and professional consequences. Materials and methods. We aimed to describe the patients’ perspective regarding the impact of IBD on their overall QoL and to evaluate the differences between men and women. An observational cross-sectional study, that included 180 patients with IBD in clinical remission, was conducted. All the patients completed a number of 3 questionnaires in order to evaluate the general aspects of their QoL. A separate questionnaire was created regarding gender-specific issues in women …

Esophageal Atresia Associating Gastrointestinal Malformations: A Study Of Clinical Approach, Dan Alexandru Iozsa, Andreea Cristina Costea, Nicolae Sebastian Ionescu

Journal of Mind and Medical Sciences

Digestive tract malformations requiring surgical repair in association with esophageal atresia are rare occurrences. Because of this uncommon presentation of esophageal atresia, its evaluation and management are often difficult, requiring extensive workup and multiple surgical procedures. We present our experience with esophageal atresia associating gastrointestinal congenital anomalies in the last 10 years. Clinical and surgical perspectives were pointed willing to make relevant observations in matters of diagnosis and treatment strategy in these patients. Therefore, 7 cases resembling this pattern were identified – duodenal atresia and anorectal malformation being the most common coexistent malformations. All the cases exhibited technical and procedural …

The Impact Of Patient-Dependent Risk Factors On Morbidity And Mortality Following Gastric Surgery For Malignancies, Bogdan Dumitriu, Sebastian Valcea, Gabriel Andrei, Mircea Beuran

Journal of Mind and Medical Sciences

Gastric cancer remains a leading cause of mortality worldwide. The treatment for gastric cancer is multimodal, in which gastrectomy remains the only curative approach. However, gastric resection is often associated with increased morbidity and mortality rates, depending on several factors. These factors can be attributed to the patient as comorbidities or effects of the disease upon him and, on the other hand, there are risk factors independent of the patient, such as aspects of the tumor (type, staging, location), experience of the surgical and anesthetic team, logistics of the hospital, yield of adjuvant therapies etc. We recognize the fact that …

Intestinal Dysbiosis – A New Treatment Target In The Prevention Of Colorectal Cancer, Florinela-Andrada Dumitru, Sergiu Ioan Micu, Roxana Emanuela Popoiag, Marilena Musat, Andreea Daniela Caloian, Valentin Calu, Vlad Denis Constantin, Daniela Gabriela Balan, Cornelia Nitipir, Florin Enache

Journal of Mind and Medical Sciences

The gastrointestinal microbiome contains at least 100 trillion microorganisms (bacteria, viruses, fungi), whose distribution varies from the mouth to the rectum spatially and temporally throughout one's lifetime. The microbiome benefits from advancing research due to its major role in human health. Studies indicate that its functions are immunity, metabolic processes and mucosal barrier. The disturbances of these functions, dysbiosis, influence physiology, lead to diabetes, inflammatory bowel disease, obesity and colon tumorigenesis. The third most common form of cancer, colorectal cancer, is the result of many factors and genes, and although the link between dysbiosis and this type of cancer is …

How Opportune Is Multigene Testing In Metastatic Colorectal Cancer? A Review, Cristina Orlov-Slavu, Andreea Parosanu, Mihaela Olaru, Dragos Serban, Ioana Paunica, Cornelia Nitipir

Journal of Mind and Medical Sciences

Personalized treatment in oncology is the most innovative method of care. The best method to establish personalized treatment is by genetic characterization of the malignant cell.

Theoretically, the more detailed the characterization, the more effective the choice of treatment becomes. Currently, there are fast and relatively low-cost options that allow such genetic characterization. However, test results sometimes do not detect targetable alterations and, even if they do detect, the use of the treatment-alteration combination does not always generate a satisfactory oncological response.

The present paper aims to answer two questions. First, how targetable can the most common gene alterations in …

Hepatocellular Carcinoma With Extrahepatic Blood Supply From Right Renal Artery, Amir Humza Sohail, Ahmad Musa, Muhammad Salman Khan, Hassan Raza Hashmi, Basit Salam, Collin E M. Brathwaite

Department of Radiology

Extrahepatic blood supply is seen in around 17-27% of hepatocellular carcinoma lesions. Evidence suggests that this extrahepatic supply most commonly originates from a right intercostal artery (70-83%) followed by left intercostal, omental and right renal arteries. Thus a comprehensive knowledge of variations in standard vascular anatomy and cognisance of factors influencing or predicting extrahepatic blood supply in HCC is instrumental in ensuring the success of surgical and interventional procedures. We present the unusual case of a 66-year-old male with HCC in Segment I of the liver with aberrant blood supply from the right renal artery in the absence of any …

Output Consistency Scale To Standardize Ostomate Output Description In Clinical Practice And Studies, Lisa Whisenhunt, Linda Xu, Fan Yang, Jacques Izard

Food for Health: Publications

Stool descriptors have become popular due to the large diffusion of the Bristol Stool Form Scale (BSFS) via clinical studies, clinical trials, and social media. The applications have been numerous and centered around standardization of terminology that can be used by health care professionals and patients alike, as well as individuals interested in their wellness and the associated partners in the wellness industry. For a portion of the population, the digestive content is rerouted to an external manufactured pouch or bag, making the use of the BSFS visual descriptors of stool difficult. From day one post-resection surgery, ostomates are challenged …

Severely Impaired Gastric Emptying In The Setting Of An Extensive Malignancy History: A Case Of Paraneoplastic Gastroparesis, Gregory Habig, Md, Justin Robbins, Md

The Medicine Forum

Gastroparesis is a disorder of the stomach involving a delay in the emptying of gastric contents that typically presents with nausea, vomiting, early satiety, and weight loss. Though commonly associated with diabetes or as a complication of surgical procedures, etiologies stemming from paraneoplastic processes are important to consider despite often being overlooked. The case presented here describes a patient with a significant malignancy history and evidence of severely impaired gastric emptying concerning for paraneoplastic gastroparesis and highlights the evaluation, diagnosis, and management of the condition.

Effect Of Pandemic On Endoscopic Utilization In Colonic Volvulus: A Global Multicentric Study, Abhilash Perisetti Md, Hermant Goyal Md, Syed Mahanazuddin Phd, Saurabh Chandan Md, Ruthvik Allala Ba, Mariajose Rojas Md, Jonathan Kopel Phd, Sonali Sachdeva Mbbs, Mark M. Aloysius Md, Phd, Benjamin Tharian, Neil Sharma Md

Other Specialties

Introduction- Acute colonic volvulus (ACV) is a gastrointestinal emergency that results from the torsion of a segment of the colon either at the level of the sigmoid colon or cecum. It can lead to severe complications such as bowel infarction and peritonitis which can increase mortality. The COVID-19 pandemic has led to a significant reduction in endoscopic utilization globally. However, the data about endoscopy utilization in a gastrointestinal emergency such as ACV is not non-existent. Hence, we attempted to evaluate the rates of endoscopy utilization in 2020 compared to 2019 for ACV patients.

Methods- We used TriNetX, a federated cloud-based …

How “Dirty” Are The Endoscope Channels? A Systematic Review And Meta-Analysis Of Reprocessed Endoscopes, Hermant Goyal Md, Sara Larsen Ms, Abhilash Perisetti Md, Pardeep Bansal Md, Aman Ali Md, Nikolaj B. Larsen Ms, Lotte Ockert, Sven Adamsen Md, Benjamin Tharian Md, Nirav Thosani Md

Other Specialties

Introduction:

The duodenoscope elevator mechanism has been considered a culprit for multiple outbreaks from contaminated reusable patient-ready duodenoscopes. These outbreaks necessitated FDA to issue various Safety Communications and recommend endoscopy units to transition to duodenoscopes with innovative designs that ease or eliminate reprocessing. However, numerous studies have documented microbes in the channels of reprocessed gastrointestinal (GI) endoscopes, including duodenoscopes and linear echoendoscopes. Our aim is to estimate the channel contamination rate of patient-ready reprocessed GI endoscopes based on the currently available data.

Methods:

We searched PubMed, Web of Science, and Embase from January 1, 2010, until October 10, 2020, for …

Peptic Ulcer With Adherent Clot—Treat It Or Leave It: A Systematic Review And Metanalysis Of Randomized Trials, Hermant Goyal Md, Sonali Sachdeva Mbbs, Abhilash Perisetti Md, Syed Ali Amir Sherazi Md, Mark M. Aloysius Md, Phd, Aman Ali Md, Greg Enders Md, Benjamin Tharian Md, Nirav Thosani Md

Other Specialties

Introduction:

Peptic ulcer diseases (PUD) remain the most common cause of hospitalized upper GI bleeding patients (30%-60%). Upper endoscopy is needed for diagnosis, stratification, and endoscopic hemostatic therapy of these ulcers depending on the presence of stigmata of increased risk of rebleeding. PUDs with adherent clot (Forrest classification IIb) are at 20-30% risk of rebleeding with a 7% mortality rate. Recent ACG guidelines could not reach a recommendation for or against endoscopic interventions for ulcers with adherent clot resistant to vigorous irrigation. This systematic review and meta-analysis aims to analyze the randomized studies for the treatment of PUD with adherent …

1-Day Vs 3-Day Low Residue Diet For Colonoscopy Bowel Cleansing: A Systematic Review, Hermant Goyal Md, Syed Ali Amir Sherazi Md, Shweta Gupta Md, Smit Deliwala Md, Pardeep Bansal Md, Abhilash Perisetti Md, Benjamin Tharian Md, Nirav Thosani

Other Specialties

Introduction:

Colonoscopy is the best method for colon cancer screening and to evaluate bowel abnormalities, including cancer. However, good bowel preparation is essential for a successful colonoscopy. Several studies have shown Low Residue Diet (LRD) to be better tolerated without any negative effects on bowel cleansing compared to Clear Liquid Diet. Several studies have compared 1-day vs. 3-day LRD for bowel cleansing. This study aims to compare the impact of the duration of LRD for colonoscopy bowel cleansing in adult patients.

Methods:

We studied the Cochrane and MEDLINE/Ovid databases from inception to November 2020 with keywords “colonoscopy,” “bowel preparation,” “bowel …

Don't Blame The Duodenoscope Elevator, The Channels Are Contaminated As Well: A Systematic Review And Meta-Analysis, Hermant Goyal Md, Sara Larsen Ms, Abhilash Perisetti Md, Aman Ali Md, Jiannis Anastasiou Md, Nikolaj B. Larsen Ms, Lotte Ockert, Sven Adamsen Md, Benjamin Tharian Md, Nirav Thosani Md

Other Specialties

Introduction:

The elevator mechanism has been suggested as the main reason for multiple outbreaks associated with contaminated reusable patient-ready duodenoscopes. The elevator is difficult to clean even with all precautions, and specially designed brushes are recommended for proper cleaning. However, the narrow channels of the duodenoscope might pose a risk of contamination since they are prone to scratches by the insertion of various accessories creating space for microbes to hide. Our aim is to estimate the contamination rate beyond the elevator of duodenoscopes based on currently available literature.

Methods:

We searched PubMed, Web of Science, and Embase from January 1, …

Continued Aspirin Use And Bleeding Risk After Endoscopic Submucosal Dissection Of Gastric Neoplasms: A Meta-Analysis, Hermant Goyal Md, Sonali Sachdeva Mbbs, Abhilash Perisetti Md, Mark M. Aloysius Md, Saurabh Chandan Md, Benjamin Tharian Md, Nirav Thosani Md

Other Specialties

Introduction:

With the development of endoscopic technologies, the detection rate of early gastric cancer (EGC) and precancerous lesions is gradually increasing. As an effective minimally invasive therapy, endoscopic submucosal dissection (ESD) has been accepted as a standard treatment for EGC and dysplasia. However, postprocedural bleeding is one of the most common complications of ESD, with a reported incidence of 5.1%. Moreover, the effect of continued low-dose aspirin (LDA) on bleeding during the peri-ESD period is not clear.

Methods:

We searched the OVID/Medline and Google Scholar databases through June 2021 to find studies relating to continued LDA use in patients undergoing …

Working With Fellows Improves Adenoma Detection Rate During Screening Colonoscopies., Mark M Aloysius, Hemant Goyal, Niraj James Shah, Abhilash Perisetti Md, Benjamin Tharian

Other Specialties

No abstract provided.

Safety Of Glucagon Use During Endoscopic Retrograde Cholangiopancreatography: A Retrospective Multicentric Study, Abhilash Perisetti Md, Hermant Goyal Md, Syed Mahanazuddin Phd, Rupinder Mann Md, Saurabh Chandan Md, Benjamin Tharian Md, Neil Sharma Md

Other Specialties

Introduction- Injectable glucagon inhibits gastrointestinal (GI) and duodenal motility by relaxing smooth muscles, decreasing the frequency and amplitude of phasic activity of the sphincter of Oddi. This enables endoscopists to enhance biliary cannulation and extract small bile duct stone. Additionally, glucagon can potentially worsen underlying hyperglycemia and hyperkalemia especially in patients with diabetes. It is unclear if glucagon impacts the adverse events of Endoscopic Retrograde Cholangiopancreatography (ERCP) such as rates of GI bleeding, GI perforation, post-ERCP pancreatitis (PEP) and in patient hospitalizations.

Methods We used TriNetX, a federated cloud-based network comprising of 92 healthcare organizations (HCOs) across the US. All …