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Perianal Fistulizing Crohn’s Disease Combined with Pilonidal Sinus and Hidradenitis Suppurativa
Pengfei Zhou, Jingen Lu, Jiadong Zhang & Jiawen Wang
doi : 10.1007/s10620-024-08535-1
Volume 69, pages 3091–3093, (2024)
Perianal lesions are common in patients with Crohn’s disease (CD) with anal fistulae the most common [1]. Whether perianal fistulizing CD correlates with pilonidal sinus and hidradenitis suppurativa is unknown. A 29-year-old male with a history of sacrococcygeal mass for more than 4 years and a suppurative ulcerated perianal mass for more than 1 year was admitted to the hospital. The patient initially noted multiple perianal ulcers with an overflow of yellowish thick discharge that had not been adequately treated. He was initially hospitalized for worsening symptoms with a diagnosis of complex anal fistula with planned surgical treatment. On preoperative examination, the patient had CD, pilonidal sinus, and hidradenitis suppurativa. He was treated surgically and received infliximab postoperatively, with complete healing of the wound after 8 weeks (see Figs. 1, 2, 3, 4).
A Novel Endoscopic Continuous Suture for Complete Mucosal Defect Closure After Gastric Endoscopic Submucosal Dissection in a Patient After Liver Transplantation
Jiaxin Yao & Yiyu Qiao
doi : 10.1007/s10620-024-08532-4
Volume 69, pages 3094–3097, (2024)
We designed a novel continuous suture to complete closure after ESD for a well gastric differentiated adenocarcinoma. We modified a clip (ROCC-D-26-195, Micro-Tech, Nanjing, China) with a size-2/0 absorbable barbed suturing line (Covidien, Mansfield, MA, USA) adhered to one arm of the clip. Our procedure is as follows: (1) the modified clip-and-line was inserted and fixed at the distal edge of the defect (Fig. 1); (2) the second clip was fixed nearby it (Fig. 2); (3) the third clip was placed against the suture line on the opposite side (Fig. 3); (4) the line was pulled with hot biopsy forceps (FD-411UR, Olympus, Tokyo, Japan), apposing the clips; (5) The same procedure was implemented on the other side; (6) the defect was completely closed by pulling the line on the oral side (Fig. 4); and (7) additional clips were placed to achieve robust fixation of the wound and to avoid mucosal tears (Video 1).
An Atypical Presentation of Metastatic Breast Cancer as Acute Decompensated “Pseudocirrhosis”
Marina M. Sprague, Jordan L. Pace, Devin Patel, Camille Soroudi, Steven D. Hart & Monica Tincopa
doi : 10.1007/s10620-024-08531-5
Volume 69, pages 3098–3100, (2024)
A 65-year-old woman with a remote history of grade IIIa ER?+?/PR-/HER2- invasive ductal breast carcinoma status post-lumpectomy, chemotherapy, and radiation therapy was evaluated for one month of weight loss, jaundice, and abdominal pain. There was no evidence of underlying chronic liver disease. Evaluation revealed elevated alanine aminotransferase (143U/L), aspartate aminotransferase (144U/L), total bilirubin (5.2 mg/dL), conjugated bilirubin (3.7 mg/dL), and alkaline phosphatase (652U/L). Serologic and infectious studies yielded few significant findings (Table 1). Magnetic resonance cholangiopancreatography (MRCP) revealed nodular liver morphology and evidence of portal hypertension without discrete masses (Fig. 1). Liver biopsy demonstrated metastatic breast carcinoma involving the sinusoidal and vascular spaces with pericellular and periportal fibrosis, without evidence of cirrhosis (Fig. 2A). Immunochemical staining of the biopsy was positive for biomarkers of breast cancer metastasis (Fig. 2B). The extensive nodularity without histological evidence of cirrhosis led to the diagnosis of pseudocirrhosis with hepatic decompensation and portal hypertension secondary to infiltrative breast cancer.
A Case of Asymptomatic Duodenal Foreign Body Perforation
Cheng Ye, Shaopeng Sun, Xuyan Zeng, Li Xu, Yue Hu, Bin Lv & Haijun Cao
doi : 10.1007/s10620-024-08545-z
Volume 69, pages 3101–3103, (2024)
A 36-year-old man reporting no gastrointestinal symptoms underwent an upper endoscopy to confirm the failed eradication of H. pylori, performed under topical anesthesia. The duodenum was remarkable for a hair-like foreign body located on the contralateral side of the duodenal papilla (Fig. 1a and b). Routine laboratory examinations were negative; computed tomography revealed a high-density object perforating the wall of the descending duodenum without pneumoperitoneum (Fig. 2). The patient denied any history of swallowing foreign bodies.
Endoscopic Placement of a Stent for Proximal Biliary Obstruction Due to a Choledochoduodenal Fistula
Guo Zhang, Guiping Zhao, Zheng Liang & Shutian Zhang
doi : 10.1007/s10620-024-08558-8
Volume 69, pages 3104–3105, (2024)
A 78-year-old male was admitted to the hospital with the complaints of abdominal pain, fever, and jaundice, with laboratories notable for hyperbilirubinemia. Since he had undergone a cholecystectomy in the past, we suspected biliary obstruction.
Cholangioscopy Assisted Electrohydraulic Lithotripsy for the Rescue of an Impacted Stent-Stone-Complex
Sachin Hosahally Jayanna & Surinder Singh Rana
doi : 10.1007/s10620-024-08559-7
Volume 69, pages 3106–3108, (2024)
A 55-year-old woman presented with abdominal pain, vomiting, significantly elevated alkaline phosphatase (896 IU/L; N?<?124 IU/L), mildly elevated bilirubin (1.5 mg%), and elevated serum transaminases (AST 119U/L, ALT 149 U/L). She had undergone ERCP with biliary stenting and cholecystectomy four years prior, and her biliary stent was left forgotten. During ERCP, attempts to remove the stent were unsuccessful, and the stent got fractured from the distal end. Cholangiogram revealed a dumbbell-shaped filling defect with the plastic stent as well as the distal end of the T-tube embedded inside, suggesting a stent-stone complex (SSC) (Fig. 1). The SSC was fragmented by cholangioscopy-assisted electrohydraulic lithotripsy (CA-EHL) (Fig. 2), and the stent-stone complex was removed after fragmentation (Figs. 3 and 4).
Double-Scope and Double-Snare Techniques for Endoscopic Resection Appendiceal Orifice Polyp
Chih-Wen Huang, Hsu-Heng Yen & Yang-Yuan Chen
doi : 10.1007/s10620-024-08573-9
Volume 69, pages 3109–3111, (2024)
A 63-year-old female received an abdominal CT for bile duct stones, and a 2.5-cm mass was found in the cecum (Fig. 1). She received a subsequent colonoscopy, and a 2.5-cm polyp was found with a stalk extending from the appendiceal orifice (AO) (Fig. 2). Adequate snaring of the lesion was difficult for endoscopic mucosal resection (EMR).
Westernization and the Hazards of a “Taipei Personality”—Will the Incidence of IBD in Taiwan Catch Up with the West?
Angela J. Forbes
doi : 10.1007/s10620-024-08616-1
Volume 69, pages 3112–3113, (2024)
Inflammatory bowel disease (IBD) is a growing global burden for health systems [1]. Since IBD is typically diagnosed in young people, the lifetime costs of treatment, including surgeries, expensive medications, and hospitalizations, are high. Although recent developments in therapeutics can improve quality of life, they also come with high expenditures. Descriptive epidemiological studies highlight this burden by quantifying the number of new patients diagnosed with IBD (incidence) and calculating how many people who were diagnosed in the past continue to live with these chronic diseases (prevalence).
Robust Results Regarding Frailty and the Prognosis of Acute Pancreatitis
Felix Zubia-Olaskoaga
doi : 10.1007/s10620-024-08612-5
Volume 69, pages 3114–3115, (2024)
The incidence of acute pancreatitis (AP) is increasing, likely as a response to the growing prevalence of obesity and gallstones. It is currently a leading global cause of gastrointestinal hospitalization.
Tofacitinib in Ulcerative Colitis – Second-Line Therapy, First-Rate Results
Sidharth Harindranath
doi : 10.1007/s10620-024-08589-1
Volume 69, pages 3116–3118, (2024)
Inflammatory bowel diseases, including ulcerative colitis (UC) and Crohn’s disease, affect a significant proportion of the global population. In recent years, the incidence of IBD has rapidly increased in low- and middle-income (LMIC) countries [1, 2]. This rapid expansion of the number of patients with IBD in these countries has stressed the healthcare system in part due to the high cost of current therapies using biological agents
Chemical Necrosectomy for Infected Pancreatic Necrosis: Should We Get “High” On Alcohol?
Rohini Muriki, Jahangeer Basha & Sundeep Lakhtakia
doi : 10.1007/s10620-024-08607-2
Volume 69, pages 3119–3121, (2024)
Walled-off necrosis (WON) is a common local complication of acute necrotizing pancreatitis in its delayed phase. Management of symptomatic WON requires drainage, which can be accomplished endoscopically, radiologically, or surgically. Endoscopic transluminal drainage using either plastic or metal stents is the preferred method for draining periluminal WONs. Metal stents, especially lumen apposing metal stents (LAMS), due to their wider diameter, facilitate spontaneous clearance of internal debris, or on occasion serve as a port of entry for direct endoscopic necrosectomy (DEN), that can be repeated, if required. Since pseudocysts only contain liquid, they generally improve by drainage alone with transmural stents.
Navigating the “First Gastroenterology Job” Search for American and International Medical Graduates
Nikki Duong, Joseph Sleiman, Shifa Umar, Rashmi Advani & Daniela Guerrero Vinsard
doi : 10.1007/s10620-024-08555-x
Volume 69, pages 3122–3127, (2024)
GI fellowships do not mandate curricula in career development. Often, fellows resort to peer mentorship for guidance. Fellows should recognize that the path to a successful career varies greatly based on how one defines and measures success. Through introspection, fellows will be able to craft their ideal post-fellowship position that balances wants versus needs. In this article, we cover the breadth of post-fellowship opportunities available with a focus on unique considerations for LGBTQ+?and IMG trainees.
Part II: Contract Negotiation and Job Preparation–The Gastroenterology Perspective
Joseph Sleiman, Shifa Umar, Daniela Guerrero Vinsard, Nikki Duong & Rashmi Advani
doi : 10.1007/s10620-024-08556-w
Volume 69, pages 3128–3133, (2024)
GI fellowships do not mandate curricula in career development. Often, fellows resort to peer mentorship for guidance. Fellows should recognize that the path to a successful career varies greatly based on how one defines and measures success. Keywords are preferr Through introspection, fellows will be able to craft their ideal post-fellowship position that balances wants versus needs. In this article, we cover four practical tips for trainees entering the job negotiation process.
Nonsteroidal Anti-inflammatory Drugs for the Prevention of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis
Jiaxuan Zuo, Hengcun Li, Shutian Zhang & Peng Li
doi : 10.1007/s10620-024-08565-9
Volume 69, pages 3134–3146, (2024)
Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) remains the most frequent and severe complication following ERCP, elevating both patient suffering and healthcare costs, and posing challenges to the advancement of ERCP techniques. Empirical evidence supports the prophylactic use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the prevention of PEP, especially in high-risk populations, as endorsed by both the American Society for Gastrointestinal Endoscopy (ASGE) and the European Society for Gastrointestinal Endoscopy (ESGE). However, the prophylactic efficacy of NSAIDs in average-risk individuals, alongside the ideal drug selection, dosing, and timing of NSAID administration, remains to be elucidated. Furthermore, the synergistic preventive potential of NSAIDs when integrated with other interventions, such as hydration, pancreatic stenting, somatostatin administration, sublingual nitrate application, and epinephrine, warrants further clarification. In this paper, we conduct an exhaustive review of the prophylactic effect and clinical administration of NSAIDs for PEP. We comprehensively synthesize findings from clinical trials investigating NSAIDs, both in monotherapy and combination regimens, for PEP prevention. Additionally, we scrutinize the current landscape of NSAID usage in clinical practice and evaluate their cost-effectiveness. Future research should concentrate on refining NSAID prophylaxis strategies for PEP in patients at different risk levels, while also enhancing adherence to clinical guidelines and alleviating the issue of NSAID cost inflation.
Feel the Burn: RFA for Chronic Radiation Proctitis
Gabriele De Sena, Federico Maria Mongardini, Danilo Porpora, Maria Mauro, Davide Bentivoglio, Davide Centore, Luigi Brusciano, Claudio Gambardella, Augusto Lauro, Ludovico Docimo & Vincenzo Napolitano
doi : 10.1007/s10620-024-08553-z
Volume 69, pages 3147–3155, (2024)
Chronic radiation proctitis, although relatively rare, can be the source of severe comorbidity in patients who had undergone prior radiotherapy for pelvic malignancy. Although current treatments for radiation proctitis include argon plasma coagulation, heater probe, bipolar neodymium/yttrium aluminum garnet (Nd: YAG) lasers, these interventions are often burdened by the frequent occurrence of rectal ulcerations and stenosis. Since radiofrequency ablation (RFA) is frequently used to ablate esophageal malignancy and pre-malignancy, we report the efficacy of RFA using through the scope system in two patients with rectal bleeding due to radiation proctitis. In both cases, the procedure was well-tolerated with hemostasis achieved after 1 or 2 sessions of RFA. Mucosal re-epithelialization was observed in areas of previous bleeding with no stenosis or ulceration observed at follow-up.
Virtual Interviews in the Post-COVID-19 Emergency Era: Insights from the Gastroenterology Fellowship Applicants and Programs
Teresa Da Cunha, Joseph C. Anderson & Haleh Vaziri
doi : 10.1007/s10620-024-08551-1
Volume 69, pages 3156–3164, (2024)
Virtual interviews are still recommended for fellowship applications, 3 years after the beginning of the COVID-19 pandemic. Improving equity by reducing the cost for the applicants has been the most important reason for continuing virtual interviews. However, some argue that important information may be missed in a virtual setting. Our objective was to assess the perspective of Gastroenterology (GI) fellowship interviewers and applicants toward virtual interviews
Validation of Quality Assessment Measures for Inpatient Gastroenterology Consults on Oncologic Patients in Non-teaching Services at a Cancer Center: A Cross-Sectional Study
Trilokesh D. Kidambi, Rateeba Qadri, Jay Varughese, Tyler Seto, Gregory Idos, James Lin, Peter Hirsch, Harry Trieu, Huiyan Ma, Marjorie Hein, Alice Ahn, Claire Hy-Hincy, Michael W. Lew, Jonathan Kessler, Ryan B. Perumpail, Jonathan P. Terdiman, Jeffrey K. Lee, Lukejohn Day, Reza Sedighi Manesh, Randy Taplitz & Cornelia Banciu-Odell
doi : 10.1007/s10620-024-08571-x
Volume 69, pages 3165–3171, (2024)
To develop and validate tools for measuring inpatient gastroenterology (GI) consultation quality on oncologic patients.
Temporal Trends of Inflammatory Bowel Diseases in Taiwan from 2016 to 2020: A Population-Based Study
Chia-Jung Kuo, Cheng-Yu Lin, Puo-Hsien Le, Yao-Wei Kuo, Chen-Ming Hsu, Ming-Wei Lai, Wey-Ran Lin, Ming-Ling Chang, Ming-Yao Su, Cheng-Tang Chiu & Chee-Jen Chang
doi : 10.1007/s10620-024-08518-2
Volume 69, pages 3172–3179, (2024)
There are scanty population-based studies investigating the incidence and prevalence rates of inflammatory bowel disease (IBD) in Taiwan.
Assessment of Physician Needs and Access to Inflammatory Bowel Disease Specialty Care Resources in a National Integrated Health System
Shirley Cohen-Mekelburg, Jessica Johnson, Elizabeth Paine, Meena A. Prasad, Jason A. Dominitz & Jason Hou
doi : 10.1007/s10620-024-08560-0
Volume 69, pages 3180–3187, (2024)
The barriers to providing high-quality inflammatory bowel disease (IBD) care go beyond educational needs alone to include access to IBD-related resources such as medications, laboratory testing, and multidisciplinary teams. We assessed the needs and resource constraints of physicians caring for Veterans with IBD to inform efforts to improve access to high-quality care
Hidden Dangers of Frailty: Higher Mortality, Complications and Costs in Acute Pancreatitis
Nishit Patel, Janak Bahirwani, Krishna Bodrya, Dhruvanshu Patel & Yecheskel Schneider
doi : 10.1007/s10620-024-08480-z
Volume 69, pages 3188–3194, (2024)
Frailty is a clinically recognizable state of increased vulnerability due to age-related decline in reserve and function across multiple physiologic systems that compromises the ability to cope with acute stress. As frailty is being identified as an important risk factor in outcomes of gastrointestinal pathologies, we aimed to assess outcomes in patients with acute pancreatitis within this cohort.
Sex and Race-Ethnic Disparities in Metabolic Dysfunction-Associated Steatotic Liver Disease: An Analysis of 40,166 Individuals
Clarissa Elysia Fu, Margaret Teng, Daniel Tung, Vijay Ramadoss, Christen Ong, Benjamin Koh, Wen Hui Lim, Darren Jun Hao Tan, Jia Hong Koh, Benjamin Nah, Nicholas Syn, Nobuharu Tamaki, Mohammad Shadab Siddiqui, Karn Wijarnpreecha, George N. Ioannou, Atsushi Nakajima, Mazen Noureddin, Arun J. Sanyal, Cheng Han Ng & Mark Muthiah
doi : 10.1007/s10620-024-08540-4
Volume 69, pages 3195–3205, (2024)
To overcome the limitations of the term “non-alcoholic fatty liver disease” (NAFLD), the term metabolic-associated steatotic liver disease (MASLD) was introduced. While epidemiologic studies have been conducted on MASLD, there is limited evidence on its associated sex and ethnic variations
Safety of Endoscopy in Cirrhosis
Jerome C. Edelson & Don C. Rockey
doi : 10.1007/s10620-024-08539-x
Volume 69, pages 3206–3213, (2024)
Endoscopic procedures are among the most commonly performed medical procedures and the serious adverse event rate is reported to be 1–3 adverse events per 1000 procedures.
Racial and Ethnic Disparities in Outcomes After the Development of Ascites: A National Cohort Study
Quintin P. Solano, Xi Chen, Neehar D. Parikh & Elliot B. Tapper
doi : 10.1007/s10620-024-08572-w
Volume 69, pages 3214–3219, (2024)
Ascites, a severe complication of cirrhosis, significantly impacts patient morbidity and mortality especially in Black patients. Access to disease optimizing care has been proposed as a potential driver of this disparity. In this study, we evaluate TIPS utilization across racial and ethnic groups.
Discharge Outcomes of Hospitalized Patients with New Onset Decompensated Cirrhosis
Abraham Ifrah, Rachel Fromer, Alec Harrison Gayner & Ho-Man Yeung
doi : 10.1007/s10620-024-08574-8
Volume 69, pages 3220–3225, (2024)
There are a lack of data describing outcomes and follow-up after hospital discharge for patients with newly diagnosed cirrhosis with complication on index admission. This study examines factors that influence outcomes such as readmission, follow-up, and mortality for patients with newly diagnosed cirrhosis.
Inadequate Dietary Education and Poor Adherence to a High Protein, Low Sodium Diet in Cirrhosis: Mixed Methods Approach
Cristal Brown, Rabecca Hernandez, Ty Ford, Nazan Aksan, Clara DiVincenzo & Andrew J. Muir
doi : 10.1007/s10620-024-08526-2
Volume 69, pages 3226–3235, (2024)
Malnutrition in cirrhosis is associated with poor outcomes, leading to guidelines for a high protein, low sodium diet; however, there is no guidance regarding the implementation of diet education in clinical practice
Regional Heterogeneity in Intestinal Epithelial Barrier Permeability and Mesenteric Perfusion After Thoracic Spinal Cord Injury
Jackson B. Radler, Amanda R. McBride, Kushal Saha, Prashant Nighot & Gregory M. Holmes
doi : 10.1007/s10620-024-08537-z
Volume 69, pages 3236–3248, (2024)
Spinal cord injury (SCI) disrupts intestinal barrier function, thereby increasing antigen permeation and leading to poor outcomes. Despite the intestinal tract’s anatomic and physiologic heterogeneity, studies following SCI have not comprehensively addressed intestinal pathophysiology with regional specificity.
eIF6 Promotes Gastric Cancer Proliferation and Invasion by Regulating Cell Cycle
Cong-Gai Huang, Xiao-Qing Zhou, An-Fu Zheng, Xing Luo, Jing Shen, Zhan-Gang Xiao, Zhi-Hui Yang & Qiong Dai
doi : 10.1007/s10620-024-08464-z
Volume 69, pages 3249–3260, (2024)
To investigate the role and function of eIF6 in gastric cancer (GC)
NAT10 Overexpression Promotes Tumorigenesis and Epithelial–Mesenchymal Transition Through AKT Pathway in Gastric Cancer
Shenglei Song, Bo Li, Xinghan Jin, Huan Li, Huijin Wang, Fuhui Wang, Yulong He & Changhua Zhang
doi : 10.1007/s10620-024-08472-z
Volume 69, pages 3261–3275, (2024)
N-acetyltransferase 10 (NAT10), the only RNA cytosine acetyltransferase known in humans, contributes to cancer tumorigenesis and progression. This study aims to investigate the effect of NAT10 on the malignant biological properties of gastric cancer (GC) and its underlying mechanism.
Regulation of the PD-1/PD-L1 Axis and NK Cell Dysfunction by Exosomal miR-552-5p in Gastric Cancer
Chun-Wei Tang, Jin-Hua Yang, Jing-Wen Qin, Hui-Jie Wu, Hao-Peng Cui, Lian-Ying Ge & Ai-qun Liu
doi : 10.1007/s10620-024-08536-0
Volume 69, pages 3276–3289, (2024)
NK cells play a vital role in tumor immune resistance. Various factors affect NK cell activity. While NK cell dysfunction has been observed in numerous malignancies, the underlying mechanisms in gastric cancer remain unclear.
Fructose-1, 6-Bisphosphate Aldolase B Suppresses Glycolysis and Tumor Progression of Gastric Cancer
Liping Wu, Jinliang Dong, Dailiang Fei, Ting Le, Liang Xiao, Jia Liu & Ze Yu
doi : 10.1007/s10620-024-08568-6
Volume 69, pages 3290–3304, (2024)
Gastric cancer (GC) is believed to be one of the most common digestive tract malignant tumors. However, mounting evidence indicates a link between the glycolysis and tumorigenesis, including gastric cancer.
Acquired Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand (TRAIL) Resistance of Human Colorectal Cancer Cells Is Linked to Histone Acetylation and Is Synergistically Ameliorated by Combination with HDAC Inhibitors
Se Lim Kim, MinWoo Shin, Byung Chul Jin, SeungYoung Seo, Gi Won Ha & Sang Wook Kim
doi : 10.1007/s10620-024-08569-5
Volume 69, pages 3305–3317, (2024)
Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is an attractive target for the treatment of various malignancies; however, its therapeutic potential is limited because of the frequent occurrence of tumor cell resistance. In this study, we determined whether TRAIL resistance acquired by repeated administration could be overcome by HDAC inhibition in human colorectal cancer cells.
Rs12039395 Variant Influences the Expression of hsa-miR-181a-5p and PTEN Toward Colorectal Cancer Risk
Wael A. El-korany, Walid E. Zahran, Mohamed A. Alm El-Din, Hanan A. Al-Shenawy & Ahmed F. Soliman
doi : 10.1007/s10620-024-08517-3
Volume 69, pages 3318–3332, (2024)
Single nucleotide polymorphisms (SNPs) in microRNA (miRNA) genes could alter miRNA expression levels or processing and, thus, may contribute to colorectal cancer (CRC) development. Therefore, this study aimed to examine whether the MIR181A1 genomic sequence possesses SNPs that can affect the expression of hsa-miR-181a-5p and, subsequently, impact its targets and associate with CRC risk.
Circulating Markers of Necroptosis in Acute Pancreatitis
Hanna Belfrage, Krista Kuuliala, Antti Kuuliala, Harri Mustonen, Pauli Puolakkainen, Leena Kylänpää & Johanna Louhimo
doi : 10.1007/s10620-024-08530-6
Volume 69, pages 3333–3343, (2024)
Necroptosis, a programmed inflammatory cell death, is involved in the pathogenesis of acute pancreatitis (AP). We compared levels of interleukin (IL)-33 (released upon necroptosis), sST2 (soluble IL-33 receptor), MLKL, RIPK1 and RIPK3 (necroptosis executioner proteins), and proinflammatory cytokines IL-6, TNF and IL-1? at various severity categories and stages of AP.
Elemental Diet as a Therapeutic Modality: A Comprehensive Review
Jason Nasser, Sepideh Mehravar, Mark Pimentel, Jane Lim, Ruchi Mathur, Antoine Boustany & Ali Rezaie
doi : 10.1007/s10620-024-08543-1
Volume 69, pages 3344–3360, (2024)
Elemental diets have been employed for the management of various diseases for over 50 years, with several mechanisms mediating their beneficial effects. Yet, they are underutilized due to poor palatability, access, cost, and lack of awareness regarding their clinical efficacy. Therefore, in this review, we aimed to systematically search and review the literature to summarize the formulation variability, mechanisms of action, clinical applications, and tolerability of the elemental diets in gastrointestinal diseases. While large prospective trials are lacking, elemental diets appear to exhibit objective and subjective clinical benefit in several diseases, including eosinophilic esophagitis, eosinophilic gastroenteritis, inflammatory bowel diseases, small intestinal bacterial overgrowth, intestinal methanogen overgrowth, chemoradiotherapy-associated mucositis, and celiac disease. Although some data support the long-term use of elemental diets as an add-on supplement for chronic pancreatitis and Crohn’s disease, most of the literature on exclusive elemental diets focuses on inducing remission. Therefore, subsequent treatment strategies for maintaining remission need to be adopted in chronic/relapsing diseases. Several mechanistic pathways were identified to mediate the effects of elemental diets, including food additive and allergen-free content, high passive absorption rate, and anti-inflammatory properties. High rates of intolerance up to 40% are seen in the trials where exclusive elemental diets were administered orally due to poor organoleptic acceptability; however, when tolerated, adverse events were rare. Other limitations of elemental diets are cost, access, and lifestyle/social restrictions. Moreover, judicious use is advised in presence of a concomitant restrictive food intake disorders. Elemental diets offer a potentially highly efficacious dietary intervention with minor side effects. Palatability, cost, access, and social restrictions are common barriers of use. Prospective clinical trials are needed to elucidate the role of elemental formulas in the management of individual diseases.
Intestinal Methanogen Overgrowth (IMO) Is Associated with Delayed Small Bowel and Colonic Transit Time (TT) on the Wireless Motility Capsule (WMC)
Sarah Talamantes, Faye Steiner, Sean Spencer, Leila Neshatian & Irene Sonu
doi : 10.1007/s10620-024-08563-x
Volume 69, pages 3361–3368, (2024)
Methanogens are associated with gut dysmotility in animal models but have not been robustly studied in humans. The WMC assesses regional transit time (TT) and pH in the GI tract.
Examining the Impact of a GI Hospitalist Model on the Outcomes of Double-Balloon Enteroscopy: A Single-Center Retrospective Study
Shaili Babbar & Melissa Debordeaux
doi : 10.1007/s10620-024-08552-0
Volume 69, pages 3369–3374, (2024)
A GI hospitalist (GIH) is a physician who practices in the inpatient setting performing consultations and endoscopic procedures. Obscure small bowel bleeding is a common inpatient diagnosis that is difficult to manage and associated with longer hospitalizations. Having an onsite GIH physician with expertise in video capsule endoscopy (VCE) and double-balloon enteroscopy (DBE) has the potential to improve patient outcomes
Risk Factors for the Development of and Outcomes After Diagnosis of Autoimmune Alopecia Areata in Patients with Inflammatory Bowel Diseases
Yushan Pan, Evelyn Lilly & Ashwin N. Ananthakrishnan
doi : 10.1007/s10620-024-08575-7
Volume 69, pages 3375–3381, (2024)
The development of certain immune-mediated diseases (IMD) in patients with inflammatory bowel diseases [IBD; Crohn’s disease (CD), ulcerative colitis (UC)] has been linked to treatment of IBD. Hair loss in some patients may be due to immune-mediated alopecia areata (AA). Risk factors and outcomes of AA in patients with IBD have not been previously explored.
Upper Gastrointestinal Involvement in Crohn’s Disease as an Independent Predictor of New-Onset Strictures: Insights from an Extensive Retrospective Cohort Analysis
Wei-Chun Hsu, Chien-Ming Chen, Chia-Jung Kuo, Yung-Kuan Tsou, Pai-Jui Yeh, Ming?Wei Lai, Ren-Chin Wu, Cheng-Tang Chiu, Ming?Yao Su, Yu-Bin Pan & Puo-Hsien Le
doi : 10.1007/s10620-024-08577-5
Volume 69, pages 3382–3391, (2024)
Crohn’s Disease (CD) can affect the entire gastrointestinal tract, including the upper sections (UGI), which is often overlooked, especially in Asian populations. There’s a notable gap in research regarding the impact of UGI involvement on the intricate landscape of ensuing complications. This study aims to address this gap.
Pelvic Radiation Therapy Increases Risk of Pouch Failure in Patients with Inflammatory Bowel Disease and Ileal Pouch
Karthik Gnanapandithan, Laura G. Stuessel, Bo Shen, Fadi H. Mourad, Zhongwei Peng, Francis A. Farraye & Jana G. Hashash
doi : 10.1007/s10620-024-08576-6
Volume 69, pages 3392–3401, (2024)
The effect of radiation on the ileal pouch is less well studied in patients with inflammatory bowel disease (IBD) and ileal pouch-anal anastomosis.
Intestinal Ultrasonography as an Alternative to Fecal Calprotectin to Monitor Patients with Crohn’s Disease: Experience from a Novice Sonographer
Kelly Mathieu, Jérémy Junda, Régine Minet-Quinard, Dilek Coban, Marie Dodel, Bruno Pereira & Anthony Buisson
doi : 10.1007/s10620-024-08548-w
Volume 69, pages 3402–3412, (2024)
While fecal calprotectin (Fcal) is now recommended, the positioning of intestinal ultrasonography (IUS) is still unknown to monitor patients with CD
Hypertriglyceridemia, Hypercholesterolemia, Body Mass Index, and the Risk of Acute Pancreatitis
Qiu Sun, Liming Du, Qingshuai Ren, Guoling Zhu, Bing Zhang, Afang Su, Shouling Wu & Shuohua Chen
doi : 10.1007/s10620-024-08493-8
Volume 69, pages 3413–3425, (2024)
The purpose of this work was to check the connection between parameters of lipid profile and body mass index (BMI) in relation to the occurrence of acute pancreatitis within a sample of adults from northern China
Development and Validation of a Clinical Predictive Nomogram for Assessing the Risk of Recurrence of Acute Pancreatitis in Combined Hypertriglyceridemia
Shuaiyong Wen, Yu Zhang, Guijie Zhao, Kun Zhang & Yunfeng Cui
doi : 10.1007/s10620-024-08578-4
Volume 69, pages 3426–3435, (2024)
The objective of this study is to develop and validate a new nomogram-based scoring system for anticipating the recurrence of acute pancreatitis (AP) in combined hypertriglyceridemia (HTG).
Hyponatremia Is Associated with Mortality in Acute Pancreatitis Patients
Liqing Song, Wen Tang, Mei Feng, Menglin Tang, Yulan Luo, Qiaolian Li, Lin Hu, Fengming Zhang & Ying Xu
doi : 10.1007/s10620-024-08495-6
Volume 69, pages 3436–3441, (2024)
Disorders of serum sodium are common among general patients and are associated with poor outcomes. The prognostic value of serum sodium disorders in patients with acute pancreatitis (AP) has not been studied. We conducted this retrospective study to explore the association between serum sodium levels and the outcomes of patients with AP.
Indomethacin Does Not Reduce Post-ERCP Pancreatitis in High-Risk Patients Receiving Pancreatic Stenting
Bingqing Bai, Shaofei Wang, Yemei Du, Mengwen Li, Qiming Huang, Sisi Liu, Chenyu Zhang, Yuanyuan Fang, Xinwen Chen, Jianglong Hong, Yang Li, Zhangwei Xu, Xiaochang Liu, Rutao Hong, Junjun Bao & Qiao Mei
doi : 10.1007/s10620-024-08542-2
Volume 69, pages 3442–3449, (2024)
Rectal indomethacin reduces pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP). However, there is insufficient evidence regarding its added benefits in patients already receiving prophylactic pancreatic stenting. Our goal was to evaluate the impact of indomethacin in high-risk patients undergoing pancreatic stenting
Early Drain Removal Versus Routine Drain Removal After Pancreaticoduodenectomy and/or Distal Pancreatectomy: A Meta-Analysis and Systematic Review
Shiqi Zhu, Minyue Yin, Wei Xu, Chenghao Lu, Shuo Feng, Chunfang Xu & Jinzhou Zhu
doi : 10.1007/s10620-024-08547-x
Volume 69, pages 3450–3465, (2024)
Early drain removal (EDR) has been widely accepted, but not been routinely used in patients after pancreaticoduodenectomy (PD) and distal pancreatectomy (DP). This study aimed to evaluate the safety and benefits of EDR versus routine drain removal (RDR) after PD or DP.
Comparative Efficacy and Safety of Different Stent Types for Pancreatic Fluid Collections: A Systematic Review and Network Meta-Analysis
Faisal Kamal, Muhammad Aziz, Wade Lee-Smith, Sachit Sharma, Ashu Acharya, Muhammad Ali Khan, Umer Farooq, Zahid Ijaz Tarar, Manesh Kumar Gangwani, Umar Hayat, Anand Kumar, Alexander Schlacterman, Thomas Kowalski & Douglas G. Adler
doi : 10.1007/s10620-024-08538-y
Volume 69, pages 3466–3480, (2024)
Drainage of pancreatic fluid collections (PFCs) is required in select cases including infected or symptomatic collections. In this network meta-analysis, we have compared lumen-apposing metal stents (LAMS), fully covered self-expandable metal stents (FCSEMS), and double-pigtail stents (DPS) to identify the most useful stent type in the management of PFCs.
Safety and Efficacy of Covered Self-Expandable Metallic Stent for Choledochojejunal Anastomotic Stricture: A Multi-Center Retrospective Cohort Study
Yuhei Iwasa, Takuji Iwashita, Keisuke Iwata, Mitsuru Okuno, Kota Shimojo, Shinya Uemura, Ryuichi Tezuka, Akihiko Senju, Shota Iwata & Masahito Shimizu
doi : 10.1007/s10620-024-08561-z
Volume 69, pages 3481–3487, (2024)
Benign choledochojejunal anastomotic stricture (CJS) is a complication of pancreaticoduodenectomy and choledochojejunostomy. Typically managed with endoscopic balloon dilatation, CJS has a high recurrence rate. Covered metallic stent (CMS) placement is a potential alternative; however, a comprehensive evaluation is lacking
Rationale for Hepatitis C Virus Treatment During Hematopoietic Stem Cell Transplant in the Era of Novel Direct-Acting Antivirals
Zachary Makovich, Ivana Radosavljevic, Shreya Chapyala, Guy Handley, Luis Pena, Shaffer Mok & Mark Friedman
doi : 10.1007/s10620-024-08541-3
Volume 69, pages 3488–3500, (2024)
Untreated hepatitis C (HCV) infection in patients undergoing hematopoietic stem cell transplantation (HSCT) can lead to worse outcomes. Traditionally, HSCT patients infected with HCV would wait until after immune reconstitution to receive HCV therapy, as the oncologic urgency of transplant would not allow time for a full preceding treatment course of HCV therapy. However, in the era of newer direct-acting antivirals (DAAs), we propose that concomitant treatment of HCV while undergoing HSCT is safe and feasible, while keeping in mind potential drug-drug interactions.
Benefits of Hepatitis C Viral Eradication: A Real-World Nationwide Cohort Study in Taiwan
Chin-Wei Chang, Wei-Fan Hsu, Kuo-Chih Tseng, Chi-Yi Chen, Pin-Nan Cheng, Chao-Hung Hung, Ching-Chu Lo, Ming-Jong Bair, Chien-Hung Chen, Pei-Lun Lee, Chun-Yen Lin, Hsing-Tao Kuo, Chun-Ting Chen, Chi-Chieh Yang, Jee-Fu Huang, Chi-Ming Tai, Jui-Ting Hu, Chih-Lang Lin, Wei-Wen Su, Wei-Lun Tsai, Yi-Hsiang Huang, Chien-Yu Cheng, Chih-Lin Lin, Chia-Chi Wang, …Cheng-Yuan Peng Show authors
doi : 10.1007/s10620-024-08512-8
Volume 69, pages 3501–3512, (2024)
Chronic hepatitis C (CHC) increases the risk of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). This nationwide cohort study assessed the effectiveness of viral eradication of CHC.
Etiology-Specific Effects of Impaired Functional Status on Liver Transplant Outcomes
David Uihwan Lee, Kuntal Bhowmick, Aldanah Althwanay, Sarah Sandlow, Michal Wiseman, Ki Jung Lee, Gregory Hongyuan Fan, Hannah Chou, Harrison Chou, Kimberly Schuster, KeeSeok Lee & Zurabi Lominadze
doi : 10.1007/s10620-024-08522-6
Volume 69, pages 3513–3553, (2024)
Pre-liver transplant (LT) functional status is an important determinant of prognosis post LT. There is insufficient data on how functional status affects outcomes of transplant recipients based on the specific etiology of liver disease. We stratified LT recipients by etiology of liver disease to evaluate the effects of functional status on post-LT prognosis in each subgroup.
Burden of Portal Hypertension Complications Is Greater in Liver Transplant Wait-Listed Registrants with End-Stage Liver Disease and Type 2 Diabetes
Idris Yakubu, Sean Flynn, Hiba Khan, Madison Nguyen, Rehan Razzaq, Vaishali Patel, Vinay Kumaran, Amit Sharma & Mohammad Shadab Siddiqui
doi : 10.1007/s10620-024-08499-2
Volume 69, pages 3554–3562, (2024)
Impact of type 2 diabetes mellitus (T2DM) in patients with end-stage liver disease (ESLD) awaiting liver transplantation (LT) remains poorly defined. The objective of the present study is to evaluate the relationship between T2DM and clinical outcomes among patients with LT waitlist registrants. We hypothesize that the presence of T2DM will be associated with worse clinical outcomes.
Clinical Characteristics and Prognosis of Early-Onset Hepatocellular Carcinoma: A Retrospective Cohort Study Based on Population Data
Yufan Guan, Yu Gan & Jiaze An
doi : 10.1007/s10620-024-08549-9
Volume 69, pages 3563–3573, (2024)
The incidence of young patients diagnosed with hepatocellular carcinoma (HCC) is projected to rise. This study aimed to investigate the distinctive characteristics of adolescent and young adult (AYA) patients with HCC and identify the risk factors that impact their survival.
