Archive

Peripheral Blood Platelet Counts Identify Prognostically Diverse Clinical Phenotypes in Hepatocellular Carcinoma

Brian I Carr*; Harika Gozukara Bag; Sezai Yilmaz

    The factors responsible for Hepatocellular Carcinoma (HCC) growth are not precisely known. `To study the clinical parameters associated with increases in Maximum Tumor Diameter (MTD).


The Weak Relationship between Elevated Serum Alpha-Fetoprotein Levels and Tumor Characteristics, but strong Relationship to Survival in Hepatocellular Carcinoma Patients

Brian I Carr*; Vito Guerra; Volkan Ince; Burak Isik; Sezai Yilmaz

    lpha-Fetoprotein (AFP) is an oncofetal-protein that is an important prognostic biomarker in Hepato Cellular Carcinoma (HCC) patients, yet the reasons for this importance are unclear. We aimed to evaluate the relationships between AFP and Maximum Tumor Diameter (MTD), multifocality, Portal Vein Thrombosis (PVT) and survival.


An Acute Gastroenteritis Outbreak Caused by Enteropathogenic Escherichia Coli (EPEC) in China

Peng Zhang; Liping Chen*; Wei Yan; Zhiqiang Liang; Lei Ji

    Background: Foodborne diseases or foodborne diarrhea are important reasons affecting the global population. Diarrheagenic E. coli is the most important pathogens, which causes diarrhea in humans. On May 27, 2022, Anji County Hospital of Chinese Medicine treated several patients with acute onset of gastroenteritis. It was found that this was an outbreak caused by two different EPECs.


Duodenal Pseudomelanosis: A Case-Series of an Incidental Findings on Esophagogastroduodenos-Copy in Patients with Epigastric Pain

Saraswathi Lakkasani*; Ummul Asfeen DO; Srinivas Pantula; Taherunnisa Rida; Keerthana Reddy Bondugula; Devna Lakkasani; Yatinder Bains

    Duodenal Pseudomelanosis (DP) also known as pseudomelanosis duodeni is an uncommon entity characterized by upper endoscopic evidence of specks of black- brownish pigmentation of the mucosal layer in the duodenum. Pseudo-melanosis duodeni is commonly seen in females and mostly middle-aged to elderly populations. Pigment (ferrous sulfide) laden macrophages collect in the normal villi of the duodenum.


Duodenal Ulcer-The Baby Version Why Pyloric Stenosis of Infancy (PS) Occurs

Ian Munro Rogers

    The connection between Pyloric Stenosis of Infancy (PS) with Duodenal Ulcer (DU) in adults is undeniable. Both occur predominantly in males and in the same ratio-5/1. Both have a familial basis [1] and both have hyperacidity [2,3,4] which is fundamental to pathogenesis. In both conditions blood group O-the blood group associated with hyperacidity -predominates [5,6] and presumably reflects a parietal mass at the top of the normal range.


The Long-Term Effects and Outcomes of Covid-19 on Elevated Liver Function Tests

Pooja Shah; Kristie Searcy; Lovekirat Dhaliwal; Muhammed Remani; Dhruvkumar Patel; Daniyal Raza; Aditya Vyas; Mohammad Alfrad Nobel Bhuiyan; Maryam Mubashir; Syed Musa Raza; Shazia Rashid; Ioannis Papayannis*; Qiang Cai*

    Although Coronavirus disease 2019 (COVID-19) primarily involves the respiratory system, it can also progress to a multisystem illness frequently involving the gastrointestinal tract. It is commonly observed that COVID elevates Liver Function Tests (LFTs) during an acute infection, but not much has been published about the effects once the infection clears. We investigated outcomes of elevated LFTs during a COVID infection as well as long-term LFTs.


Double IC Valve: A Rare, Surprising Sequalae of Ileocecal Tuberculosis

Dipankar Das*; Vinod Kumar; V K Dixit; Aakash Shah

    A 28-year-old male patient presented to us with chief complaints of mild intermittent non radiating pain abdomen, in right lower abdomen for 2 months, along with significant weight loss. Routine investigations were done which was suggestive of Anaemia (Hb 10gm/dl), lower serum albumin 3.4mg/dl, increased ESR.


Deployment of Artificial Intelligence for Assessment of Response to Systemic Therapies in Colorectal Cancer

Andrew Lotfalla*; David Khalil; Sakshi Khurana; Andrew Liu; Volkan Beylergil; Laurent Dercle

    Colorectal cancer is one of the leading causes of cancer worldwide, accounting for over 25% of cancers and 35% of cancer-related deaths across the globe [1,2]. Liver metastases present in more than half of colorectal cancer cases [3]. Therefore, personalized therapy and evaluation of changes in tumor size are pivotal for treatment success.


Herb-Induced Liver Injury and Acute-On-Chronic Liver Failure

Jonathan Soldera

    Acute-on-Chronic Liver Failure (ACLF) is a necessary step between decompensated cirrhosis and death. It is generally thought of as a multi-organ failure associated with decompensated cirrhosis, with a high chance of death. Herb-induced Liver Injury (HILI) is the term used for acute liver injury caused by herbal and dietary supplements, and this might disarrange a previously compensated cirrhotic patient, precipitating ACLF.


The Anti-Oxidant and Anti-Inflammatory Effects of Elaeagnus Angustifolia L. Extract on Cirrhotic Patients, a Randomized Placebo-Controlled Clinical Trial

Mahvash Alizade Naini; Soheila Rahimi; Gholam Reza Sivandzade;Farnaz Banaee; Maryam Ekramzadeh*

    Cirrhosis, a prevalent manifestation of chronic liver disease, is associated with a high risk of morbidity and mortality. Previous research has examined the function of oxidative stress and the therapeutic effects of various herbs, albeit with ambiguous results. E. Angustifolia L.’s influence on malondialdehyde (MDA) and tumour necrosis factor- (TNF-) in cirrhosis was evaluated for the first time in the present investigation.


Hepatitis C Care Cascade Incarcerated or Detained Persons and General Population in California, 2011-2021

Kaufman HW*; Meyer III WA; Huang X

    To evaluate the Centers for Disease Control and Prevention hepatitis C care cascade, that assesses hepatitis C follow-up testing and laboratory evidence of likely clearance/cure and recurrent viremia, among Californian incarcerated or detained persons (IDP) and general populations.


Systematic Review of the Bacterial Microbiome in Patients with Esophageal Cancer

Sanne JM Hoefnagel*ⴕ; Juan P Reyes Genereⴕ; Bhaskar Roy; Eugene B Chang; Kausilia K Krishnadath; Kenneth K Wang

    Purpose: Esophageal Squamous Cell Carcinoma (ESCC) and Adenocarcinoma (EAC) are common and deadly diseases. The gut microbiome has been implicated in cancer development, yet its role in esophageal cancer (EC) pathogenesis remains unclear.
Methods: We performed a systematic review to summarize the literature on the microbiome and EC. Three databases were queried for studies performing microbial analysis in Barrett’s Esophagus, EAC and ESCC.


Diagnosis of Inflammatory Bowel Disease in Mildly Elevated Faecal Calprotectin: Observation from a Clinical Audit in District Hospital in the UK

Shamnad Shakeer

    Faecal calprotectin (FC) is a marker to diagnose Inflammatory bowel disease (IBD), that is Ulcerative Colitis & Crohn’s Disease. Identifying IBD from other gut related disorder is of prime importance in managing the condition. Faecal calprotectin is cheap and non-invasive, it also helps in assessing the further need of any possible invasive procedure such as colonoscopy or imaging studies. The main objective of this observational study was to diagnose new IBD in mildly raised faecal calprotectin value(60ug/g-300ug/g). This study was done in a district-level hospital in the UK...


Association between Celiac Disease and Microbiome

Sara Deumić*; Neira Crnčević; Mirsada Hukić; Monia Avdić

    Celiac Disease (CD) represents an immune-mediated disorder that involves the body’s inability to digest gluten properly. After contact with gluten, patients of all ages might experience symptoms such as bloating, diarrhea, gas, growth issues, and anemia. In the past two decades, its prevalence has drastically increased worldwide, so the need for a better understanding of this disease and novel potential treatment options has never been greater. Today, patients are still advised to follow a completely gluten-free traditional gold standard CD diet...


A Retrospective Comparison of the Assessment Results of our Geriatric Patients with 3 Different Pain Scales, with Insidential Abdominal Pain during the Covid 19 Pandemic

Ertuğrul Allahverdi; Tülay Diken Allahverdi*

    Aim: Our aim in this study; It is aimed to accurately evaluate the pain in our patients with abdominal pain and general pain in the body with different measurement and scoring methods and to determine an effective treatment regimen.
Material and method: Our patients with acute symptoms diagnosed with COVID-19 were hospitalized, followed up and treated in our COVID Services in our Medical Faculty Health Research and Application Center hospital between November and December 2020...


Caustic Ingestion of Hydrogen Peroxide and Hepatic Portal Venous Gas: A Case Report and Literature Review

Emily Truong*; Jamie Yang; Christina Tan; Mark Noah

    Background: Hydrogen peroxide (H2O2) ingestion is associated with caustic injury and gaseous oxygen production that may cause Hepatic Portal Venous Gas (HPVG) and air embolism leading to mesenteric ischemia and CNS infarction with ensuing encephalopathy, seizures, and even death...


Rifaximin and Metronidazole Combination in the Management of Diarrhea Associated with Mixed Infection, Irritable Bowel Syndrome, and Inflammatory Bowel Disease

Arif A Faruqui

    Diarrhoea is usually a symptom of a bowel infection and the etiology of infectious diarrhea is generally mixed. Development of resistance to anti-microbial agents and increased risk of developing clostridium difficile-associated diarrhoea pose a new threat. In combination with metronidazole, rifaximin with its unique properties and broad spectrum activity can be a rational approach for infectious diarrhoea as co-infection is the norm in majority of the patients...


Alternative Administration of Artificial Feeding with Hemp Oil in a Patient with Esophageal Ca

Maroulla D Nikolaki*; Kalliopi D Synodinou; Konstantinos N Katsas; Arezina N Kasti

    Esophageal Cancer (EC) has the sixth-worst prognosis because of its aggressiveness and poor survival. Patients with EC are malnourished due to anorexia, dysphagia, pain, and hypercatabolic state, which results in cancer cachexia and high mortality rates. Oral feeding usually remains inadequate to cover nutritional needs, while Enteral Nutrition (EN) remains the recommended solution...


Over Tipping: Understanding Cerebral Edema as a Complication of TIPS in a Cirrhotic Patient

Sameer Bhalla*; Perry Rabin; Justin Mitchell; Sheila Eswaran

    Transjugular Intrahepatic Portosystemic Shunt (TIPS) is an established treatment for complications of decompensated liver cirrhosis causing portal hypertension. Hepatic encephalopathy is a frequent complication of TIPS; however, cerebral edema, which is more commonly seen in acute liver failure, has rarely been reported in chronic liver failure or post-TIPS. There are multiple proposed mechanisms that may contribute to cerebral edema after TIPS placement, but few established risk factors or treatment options exist...


Primary Biliary Cholangitis and its Diagnostic Challenges in a resource poor setting

Ijarotimi O*; Osasona EO; Betiku OA; Adekanle O; Ndububa DA

    Primary Biliary Cholangitis (PBC) is a chronic cholestatic disease of the liver. Due to the permanent cholestasis, fibrosis and cirrhosis eventually occur. It is said to be a rare disease in black Africans. We reported a case of Anti-Mitochondrial Antibody (AMA) negative PBC in a forty-one-year-old woman who fulfilled two out of the three diagnostic criteria...


Cure of the Intestinal Disorders

Michael Vladislavovich Tyurin

    We proposed human intestine as the gate for the delivery of the therapeutic recombinant proteins expressed inside of the human body. The normal intestinal microflora was used to express the selected genes of the pathogenic organism Yersinia pestis the causative agent for plug in humans and animals. We have confirmed the production of the selected proteins by the PCR to their DNAs expressed in intestinal bifidobacteria chosen...


Cure of Gastrointestinal Discomfort at Home

Michael Vladislavovich Tyurin

    Gastrointestinal disorders are a very common problem sometimes in a variety of people. We herein offer our methodology to cure such disorders in any condition, including home environment, by the two simple and reproducible methods, which anyone could reproduce and use.


Severe Gastrointestinal Manifestations of COVID-19

Tavia M Buysse; Sameer Bhalla; VIkram S Kotwal*

    The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic began almost 2 years ago but new and rare complications are still being reported. It is well known that COVID-19 infection is commonly accompanied by Gastrointestinal (GI) symptoms, including dysgeusia, nausea, vomiting, diarrhea, and abdominal discomfort...


Mortality and Morbidity due to Constipation Associated with the Use of Clozapine

Devanshi Mehta; Austin R. Swisher; Saad A. Ansari; Jasninder Dhaliwal; Aditya Desai*; Nandini Gowda

    Background: There are several serious side effects associated with the use of clozapine, an atypical antipsychotic medication. Constipation, however, is an increasingly overlooked side effect that has resulted in fatal complications. We present the case of a patient with severe constipation due to long-term use of clozapine.


Adderall Delaying Colorectal Cancer Diagnosis

Andriy Barchuk

    Colon and rectal cancer is the third most common cancer accounting for 1.93 million new cases in the year 2020. It is the second most common cause of cancer deaths in recent years. Newest guidelines suggest screening for colorectal cancer starting at the age of 45 for average-risk individuals of 40 years old or 10 years prior to youngest affected first-degree relative under the age of 60 or two or more first-degree relatives at any age with colorectal cancer or advanced polyp...


An Unexpected Liver Tumor Finding During Multiorgan Harvesting: Steatohepatitis Matters

Rendina M*; Scalera I; Nenna R; Castellaneta A; Guido R; Avolio AW; Gesualdo L; Di Leo A; Lupo LG

    The burden of Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH) are increasing worldwide. Growing evidences showed its ability to prog- ress to Hepatocellular Carcinoma (HCC). In the transplant field, NAFLD is the most common cause of discarding the livers and, to further complicates matters, the high preva- lence of NAFLD-associated HCC in the absence of cirrhosis could be a factor jeopardizing the complex transplant chain...


Lower Gastrointestinal Disease Pattern in Sudan

Gamal Eldin HA El Shallaly*; Babiker AB Ibrahim; Mohamed MI Elhajahmed; Modather ME Salih; Mohammed FEMohammed; Ibrahim AO Ali

    Objectives: Data on lower Gastrointestinal (GI) disease are generally sparse. In addition, the pattern of GI disease is changing over time.
The objectives of this study were to identify the main indications and associated endoscopic findings in patients presenting for elective lower GI endoscopy at a major teaching hospital, thus provide database and identify the current pattern of lower GI disease in our community.


Plasma Malondialdehyde Level is a Good Predictor of Portal Hypertension in Egyptian Cirrhotic Patients

Kareem Abd El-hafeez; Ahmed EL-khattib; Enas Allam; Nourhan Thabet; Safaa R Askar*

    Background and aim: Malondialdehyde (MDA) results from lipid peroxidation of polyunsaturated fatty acids and it is a marker for oxidative stress. Its level is higher in cirrhotic patients with viral etiology than in matched healthy controls. So, it may strongly correlate with Portal Hypertension (PH) in cirrhotic patients. This work aims at evaluation of the relevance between plasma MDA level and portal hypertension in cirrhotic patients.


Esophageal Large Cell Neuroendocrine Carcinoma: An Unique Consult Case from China and Lessons Learned

Zhu Lan; Qingqing Wu; Yue-Hua Zhang; Gang He*

    For years, we have conducted telepathology consultation for cancer patients from China. Major discrepancies in diagnosis were identified in all cases. Herein, we focus on one unique case of esophageal large cell neuroendocrine carcinoma to illustrate differences in pathology practice patterns between American and Chinese pathologists.


A Rare Endoscopic Image of an Esophageal Angiodysplasia

Christos Sotiropoulos*; Georgios Theocharis

    We report a 69-year-old man with a medical history of Myasthenia Gravis diagnosed 10 years before and treated with pyridostigmine who was admitted to the hospital due to microcytic anemia and hyponatremia in a routine blood test. The laboratory values revealed microcytic anemia (Hct: 20, 40%, Hb: 6.30 g/dl, MCV: 75 ,30 fl, MCH: 23, 20 pg, MCHC: 30.90 g/dl) and hyponatremia (Na: 121 mmol/l)...


Comparison of the Effect of Dexamethasone and Ondansetron in the Prevention of Nausea, Vomiting and Delirium in Children Under Endoscopy Under Anesthesia

Nassaj M; Madani SR*; Pahlavani H; Azadchehr M; Sabzpoushan A

    Introduction: Gastrointestinal endoscopy is one of the most important diagnostic and therapeutic methods that is being performed in children day by day. Nausea vomiting, delirium, bronchospasm, and laryngospasm after anesthesia are the most common complications after endoscopy in children. These complications may cause anxiety and fear to both the patient and their companions...


COVID-19 and Acute Appendicitis

Kyoo-Yoon Choi*; Michael Kwan; Lindsay Delmar; Jan Grendar; Indraneel Datta

    Objective: To compare the rate of uncomplicated and complicated acute appendicitis, and their management strategies between the COVID-19 pandemic period and the control group.
Summary background data: Literature shows significant reduction in the emergency department visit due to patients’ fear of contracting the COVID-19. Healthcare professionals are concerned that this may lead to delayed presentations of high acuity illnesses...


The Change in Upper Gastrointestinal Disease Pattern in Sudan

Gamal Eldin Hussein A El Shallaly*; Babiker AB Ibrahim; Hassan EH Mohamed Ahmed; Mohamed MI Elhajahmed; Modather ME Salih; Mohammed FE Mohammed; Ibrahim AOAli

    Objectives: Data on GastroIntestinal (GI) disease from developing countries are lacking. In addition, the pattern of GI disease is changing over time.
The objectives of this study were to identify the main indications and associated endoscopic findings in patients presenting for elective upper GI endoscopy at a major teaching hospital, thus identifying the current pattern of GI disease and the changes that occurred over the past decades.


Hemoperitoneum as First Manifestation of Advanced Prostate Cancer

Pantzios Spyridon*; Katsaros Odysseas; Antonia Syriha; Ptohis Nikolaos; Elefsiniotis Ioannis

    Metastatic prostate cancer seldomly affects the liver. Moreover, hemoperitoneum is an un-common manifestation of metastatic liver cancer and it has never been reported to be caused by rupture of hepatic metastatic lesions secondary to prostate adenocarcinoma. We describe a case of advanced prostate cancer with liver metastases, presenting with hemoperitoneum, which was successfully treated. Treatment included transarterial embolization, blood transfusions and hormonal therapy...


Severe Hemobilia Due to Arterio-Biliary Fistula. Diagnosis and Treatment by Endoscopic Ultrasound

Maryana Bozhychko; Carolina Mangas-Sanjuan; Sandra Baile-Maxía; Lucia Medina-Prado; Juan Francisco Martinez; Juan Antonio Casellas; José Ramón Aparicio*

    Hemobilia or bleeding from the hepatobiliary tract and is an uncommon cause of upper gastrointestinal bleeding that it may be caused by iatrogenic biliary injury, malignancy or vascular malformations [1]. The management of significant hemobilia is focused on arterial embolization, however biliary stents have become accepted as alternative therapies [2].


Abdominal Distention Due to Anal Stenosis

Hannes Ruymbeke*; Danny De Looze

    A 30-year old man presented to the Gastroenterology Department with diffuse abdominal pain, distention and constipation. He was born with an imperforate anus, treated by posterior sagittal anorectoplasty and construction of a neo-anus. He developed an anal stenosis for which he had numerous dilations during childhood. During recent years he defecated by means of active straining and manual abdominal pressure...


Early Life Events Related to Prematurity Can Lead to Increased Rates of Video Capsule Retention in Children

Jericho H*; Verma R; Sentongo T; Semrad C

    Video Capsule Endoscopy (VCE) allows examination of the entire length of the small bowel not visualized by standard Esophagogastroduodenoscopy (EGD) and colonoscopy. The main indications are for suspected small bowel bleeding and diagnosis and management of small bowel Crohn’s disease (CD). It is a safe procedure to perform in adults and children with the greatest risk being capsule retention. Contraindications to VCE include patients with gastrointestinal obstructions, strictures or fistulas and patients with implanted electromedical devices.


Clinical Characteristics and Outcomes of Inflammatory Bowel Disease Associated with Primary Sclerosing Cholangitis in Northeastern Brazil

Amanda da Costa Rocha; Michelle Soeiro de Oliveira; Yan Bruno Colares Botelho; Christopher Falcao Correia; Jose Armando Pessoa Neto; Ranna Carolina Bezerra Siebra; Isabele Sa Silveira Melo; Marcellus Henrique Loyola Souza Ponte; Lucia Libanez Bessa Campelo Braga*

    Background: Primary Sclerosing Cholangitis (PSC) is a chronic cholestatic liver and is highly associated with Inflammatory Bowel Disease (IBD).
Objective: Our aim was to evaluate the prevalence of PSC, phenotypic characteristics, outcomes in a cohort of IBD patients from a single-center in Northeastern of Brazil.
Methods: Data were analyzed retrospectively; risk factors of Ulcerative Colitis (UC)-PSC were compared with UC alone.


Myths Associated with Gastro-Intestinal Diseases in Northeren India

Parveen Malhotra*; Vani Malhotra; Usha Gupta; Yogesh Sanwariya; Isha Pahuja; Akshay

    Background: Gastro-intestinal disease account for significant proportion of patient load not only on Gastroenterology specialists but also on General physician and surgeons. These patients can have varied manifestations and mimic disease pertaining to many different organs leading to multiple myths associated with them.
Discussion: Gastro-intestinal disease can have different clinical presentation, most common being the dyspepsia and other presentations are alteration in bowel habits, early satiety, gastro-esophageal reflux, distension or fullness of abdomen and epigastric pain.


31 Years of Discovery and the Progress of Hepatitis C Virus: 2020, Nobel Prize in Physiology or Medicine

Chayan Bhattacharjee and Aparna Mukhopadhyay*

    Nobel Prize, 2020 in Physiology or medicine were jointly given to two American scientists Harvey J. Alter and Charles M. Rice and one British Scientist Michael Houghton for the discovery of Hepatitis C virus. The Nobel committee considered four decades of research on discovery and study of this virus. Prof Alter first identified the causative agent of transfusion associated unknown hepatitis, Prof. Houghton discovered and named this causative agent Hepatitis C virus and Prof...


5 Lipoxygenase Overexpression in Polyp Tissue and Normal Tissue in Patients with Colon Polyps

Sozen M*; Turkay C; Gunduz E; Nadir I

    Aim: Arachidonic acid metabolism plays a role in the development and progression of many neoplasms through Cyclo Oxygenase (COX) and Lip Oxygenase (LOX) enzyme pathways. Over-expression of 5- Lipoxygenase (5-LOX) enzyme has been demonstrated in different human cancers. A few studies have investigated the relationship between colon neoplasms and 5-LOX enzymes. The aim of this study was to examine and compare 5-LOX expression in normal colonic tissue and polyp tissue in patients with colonic polyps.


Feasibility of Robot-Assisted Feeding Jejunostomy Tube with Barbed Sutures during Esophagectomy

Florian Richter; Thorben Moeller; Anne-Sophie Mehdorn; Jan-Niclas Kersebaum; Thomas Becker; Jan-Hendrik Egberts*

    Objective: Malnutrition is common in patients with esophageal cancer. A Feeding Jejunostomy (FJ) for enteral feeding is an effective method to improve nutritional status.
The objective of this study was to evaluate the surgical technique and advantages of Robot-Assisted Minimally Invasive Esophagectomy (RAMIE) during surgical placement of the FJ and compare it to the open procedure. Secondly the use of barbed sutures to fix the FJ to the abdominal wall was also assessed.


Hypertension Predisposes to Radiation Toxicity in a Rat Model of Localized Intestinal Irradiation

Maaike Berbée*; Junru Wang; Martin Hauer-Jensen

    Purpose: Vascular disease is believed to be a risk factor for radiation injury in normal tissues, including the intestine. Clinical studies evaluating the relationship between hypertension and radiation enteropathy have been inconclusive, possibly because most hypertensive subjects were receiving blood pressure reducing treatment. This study assessed the association between uncontrolled hypertension and intestinal radiation injury in a clinically relevant rat model.


Bacillus Clausii (O/C, SIN, N/R, T) Improves Acute Mild Colitis in Mice while In-Vivo Modulating Gut Microbiota

Franco Scaldaferri*; Cristina Graziani; Vincenzina Mora; Valentina Petito; Loris Riccardo Lopetuso; Antonio Gasbarrini; Gianluca Ianiro; Gianluca Quaranta; Luca Masucci; Maurizio Sanguinetti; Andrea Poscia; Claudia Talocco; Francesco Franceschi; Alessandro Sgambato; Pierluigi Puca

    Background: Bacillus clausii is a gram-positive spore forming bacterium, used as a probiotic. Despite its wide use in acute diarrhea, little is known about its ability to modify the intestinal microbiota.
Aims: Aim of this study is to investigate the effect of B.clausii on a mild DSS induced acute colitis in mice evaluating gut microbiota modulation.


Eagle Syndrome

Arulprakash S*; Tarun J George

    70 yr old male presented with history of throat pain of 1-month duration, sudden onset severe pain. Pain was severe with feeling of blocking sensation of throat and difficulty in swallowing movements. Pain is radiating to neck, evaluated by ENT for pharyngeal pathology and was referred for upper GI scopy to rule out esopahgeal problems. He is a diabetic and on treatment. Upper GI scopy was normal and suggested high-resolution oesophageal manometry to rule out motility disorder.


Sero-Prevalence of Hepatitis B Virus Infection Among Patients Attending at Addis Alem Primary Hospital, Bahir Dar, Northwest Ethiopia

Mekuanint Geta Alemneh*; Endalew Yizengaw; Zegeye Getaneh; Tamyalew Getahun

    Background: Hepatitis B Virus (HBV) causes severe liver disease, such as Hepatocellular Carcinoma (HCC) and life-threatening liver disease. Hepatitis B virus infection is one of the most dominant public health problems these days. Therefore, this study aimed to determine the seroprevalence of HBV infection among patients attending Addis Alem Hospital, Bahir Dar, Northwest Ethiopia.


Experience of Diagnosis and Treatment in Mesh-Related Infection After Inguinal Hernia Repair

Yuan DING; Yang HU; Yingjie HU; Jiajun FAN; Qingsong TAO*

    Objective: To investigate the diagnosis and treatment of mesh-related infection after tension-free repair of inguinal hernia.
Methods: The clinical data of 12 patients with patch infection after tension-free repair admitted to our hospital from May 2016 to June 2019 were retrospectively analyzed. Among the patients, there were 7 cases.


Traditional Chinese Medicines Maintain the Regenerating Cirrhotic Rat Liver Model After Partial Hepatectomy

Yew-Min Tzeng; Jia-Ping Wu*

    Background: Liver exposed to toxic injury have exhibited to regenerate through a compensatory growth process. The aim of this study was to establish the hepatoprotective properties of Elephantopus scaber L. in cirrhotic rat regeneration partial hepatectomy.
Methods: Cirrhosis was induced by Thioacetamide (TAA, 200 mg/kg) administration for 6, 24, 72 to 168 h, then received surgical 70% cirrhotic PHx was examined. Rats were sacrificed after 6, 24, 72 and 168 h regeneration.


Vicissitude and Seven Patterns of Arterial Supply of the Human Liver, the Significance of the Accessory Hepatic Artery

Takayoshi MIYAKI*

    The human liver usually receives blood supply from hepatic artery arising from the common hepatic artery (Figure1). One or two aberrant hepatic arteries (S,D) appear in 30% of fetal livers and 28.6 % of adult livers (Table 1), [1,2,3]. The aberrant arteries (S or D) occupy an entire lobe of the liver in high frequency. The human liver receives any of three arterial supplies; triple (MSD), double (MS, MD, SD), or single (M,S,D; Figure1, Table 1). The arterial supply of the liver has been classified into seven patterns: MSD, MS, MD, SD, M, S, D (Table 1) [4,2,3]...


Polypectomy in Screening Colonoscopies: Is the Improvement of Adherence Better Following Clinical Data Publication or Publication of Guidelines?

Daniel Pammer; Elisabeth Kammerlander-Waldmann; Daniela Penz; Arno Asaturi; Anna Hinterberger; BarbaraMajcher; Aleksandra Szymanska; Michael Trauner; Monika Ferlitsch*

    Objective: According to recent ESGE guideline adequate polypectomy technique should be used in >80% of polypectomies. Despite recommendations of snare polypectomy for small polyps (6-9mm) almost half of them are resected by forceps. The aim of this study was to analyse if the publication of clinical data or guideline have more impact on the reduction of the forceps resection rate of polyps ≥5mm.


Can the Metastatic Lymph Node Ratio Influence the Prognosis of Patients with Gastric Cancer? Preliminary Data of a Monocentric Study

Rinnovati A; Barni L; Bichi E; Qirici E; Cianchi L

    Gastric Cancer, is a frequent cancer in Italy, the mortality associated with it is still high. It is essential to detect more new prognostic factors that allow to identify patients at higher risk, to guide the new possibilities with adjuvant and neoadjuvant chemotherapies. Various prognostic factors have been identified; tumor diameter, degree and type of pathological differentiation, lymph node status, surgical resection, margins status.


A Review of the Gastrointestinal Effects Associated with COVID-19 Infections

Bailey Reid; Allyson L Spence*; Cassandra Stroup

    SARS-CoV-2, the virus that causes COVID-19, has led to an ongoing worldwide pandemic that has afflicted nearly 46 million lives world. Current clinical evidence indicates that gastrointestinal symptoms may be more prevalent across COVID-19 infections than clinicians previously realized. Furthermore, these symptoms are common among patients who present with no other COVID-19 symptoms, suggesting that these individuals may be unknowingly spreading the disease to others.


Diagnosis and Treatment of Mirizzi Syndrome: Case Report and Literature Review

Nelcido Luis Sanchez Garcia*; Ulises Periles Gordillo; Yoandy Hernandez Casas; Ihosvany Brismat Remedios; Roger Morales de la Torre; Javier Rodriguez Sosa

   The Mirizzi syndrome is a set of symptoms related to the obstruction of the common hepatic duct by an impacted stone in the cystic duct or gallbladder infundibulum. The objective of article is to describe a case of a woman with obstructive jaundice and cholangitis diagnosed by Endoscopic Retrograde Cholangiopancreatography (ERCP), and the subsequent surgical management of the patient.


Tracheo-Esophageal Fistula Identified on UGI Endoscopy in a Child with Esophageal Stricture

Anuradha Rai

   Two month old male child presented at pediatric gastroenterology clinic of a tertiary care hospital in Delhi, India with persistent cough with choking during feeding. He also had vomiting after feed. On upper gastrointestinal endoscopy, esophageal stricture was seen at 13 cm from incisor with evidence of Tracheo-esophageal fistula adjacent to stricture. He was referred to Pediatric surgery for surgical closure of fistula.


Ulcerative Colitis and Crohn Disease in Cuban Pediatric Patients

Yamila del Carmen Velazco-Villaurrutia*; Elsa Francisca Garcia-Bacallao; Idalmis Aguilera-Matos; Sarah Esther Diaz-Oliva; Alfredo Hierro Gonzalez; Licet Gonzalez Fabian; Liana Margarita Labrada Moreno

    Introduction: Inflammatory bowel disease includes ulcerative colitis and Crohn Disease (CD). About 25-30% of diagnosed patients correspond to pediatric age, with an increasing prevalence. Objective: To characterize children with ulcerative colitis and Crohn disease. Material and Method: A descriptive cross-sectional study was carried out that included 31 children with confirmed diagnoses of both entities according to the Lennard-Jones criteria, attended in the pediatric consultation of the Institute of Gastroenterology between 2017 and 2019.


Managing NAFLD Through Gut-Liver Axis Modulation: Focus on Role of Probiotics and Omega-3 Fatty Acids

Arif A Faruqui

    Non-Alcoholic Fatty Liver Disease (NAFLD) has currently emerged as common liver disorder compared to alcoholic liver disease. The prevalence of NAFLD in India varies from 9% in rural areas to 32% in urban populations. This incidence is reported to be the lowest in western India (44.1%) compared to the highest prevalence in northern states (72.4%). Available treatments are associated with certain side-effects.


Rectal Gist in a Latin America Country: A Case Report and Literature Review

Uribe RAK*; Guevara JA; Guerrero M; Cruz R; Espinoza FJ; Purizaca N; Chavez PI

    We report the case of a 75-year-old female patient with a big tumor in the lower rectum with intestinal obstruction and lower gastrointestinal bleeding history who underwent to laparotomy with tumor biopsy and terminal colostomy at another hospital in Peru. She came to our institution for clinical evaluation with pathology result of rectal gastrointestinal stromal tumor.


Lessons Learned from the First 60 Minimally Invasive Esophagectomy in Prone Position

Norberto Daniel Velasco Hernandez*; Santiago Bartolome De Battista; Maria Micaela Zicavo; Elian Maristany Bastida; Maria Florencia Hernandez

   Since the initial description of laparoscopic fundoplication in 1991 for the treatment of gastroesophageal reflux disease, different minimally invasive procedures have been developed until nowadays, when esophagectomy is performed using combined thoracoscopy and laparoscopy. The aim of our study is to analyse the intraoperative complications of minimally invasive esophagectomy in prone position.


Laparoscopic Heller Myotomy Improves Achalasia-Disease Specific Quality of Life and Health Related Quality of Life in Patients with Achalasia

Melina S Hansen*; Palle B Miliam; Soren M Neermark; Axel K Kjeldsen; Lisbeth E Hvolris

   Achalasia is a rare chronic autoimmune motility disorder of the esophagus. A curative treatment restoring the motility does not exist, however there are good options for symptom control by laparoscopic Heller myotomy (LHM). The aim of this study was to evaluate the effect of LHM in patients with achalasia and to evaluate achalasia-disease specific quality of life (achalasia-DSQoL) and health related quality of life (HRQoL).


Vascular Endothelial Growth Factor- Receptor 2 and Inflammatory Bowel Disease – Angiogenesis within all Four Layers of Inflamed Intestinal Wall

Jaroslaw Wejman*; Michal Pyzlak; Sylwia Szymanska; Joanna Ostrowska; Wieslaw Tarnowski; Dariusz Szukiewicz

    Inflammatory Bowel Disease (IBD) is defined as chronic idiopathic inflammation of the intestines which includes two gastrointestinal disorders of unknown etiology: Ulcerative Colitis (UC) and Crohn’s Disease (CD). The nature of clinical symptoms persistence is connected with different factors, among others angiogenesis plays an important role in development of changes within bowel wall. Both macro- and microscopically examined bowels from patients suffering from acute phase of IBD revealed sometimes dramatically congested vessels with hemorrhagic foci.


Hepatic System Management in COVID-19 Infection

Khloud Gamal Abd Elsalam*; Amira Ragab El Barky; Tarek M Mohamed

    The recent pandemic disease coronaviruses which spread universally are extremely pathogens for humans. It involved critical respiratory syndrome cause, extra-pulmonary manifestations, and in some times cause death as a result of massive alveolar damage and progressive respiratory failure.


Alagille syndrome with characteristic phenotype in a 7-month-old infant: Case presentation

Manuel Lara Martin*; Angel Leonardo Meras Valdesuso; Leidelen Esquivel Sosa

    The syndromic ductopenia or also known Alagille syndrome constitutes one of the causes of cholestasis in pediatrics. A genetic disorder characterized mainly by chronic cholestasis secondary to hypoplasia of the intrahepatic biliary ducts. Histological lesion is characterized by a decrease in the number of biliary ducts in the portal spaces. It is a disease with a mortality close to 20% and patients may need hepatic transplantation.


Nodular gastritis and Helicobacter pylori in paediatric patients

Idalmis Aguilera Matos*; Daime Guilarte Falcon; Sarah Esther Diaz Oliva; Liana Margarita Labrada Moreno; Yamila del Carmen Velazco Villaurrutia; Licet Gonzalez Fabian; Veronica Walwym Salas

    Nodular Gastritis in a frequent diagnosis in upper digestive endoscopies in children and much more common in those infected with Helicobacter pylori. Recent research suggests that this diagnosis in childhood may increase the risk of cancer in adulthood. With this study we aim to provide an approach to the theme at the Institute of Gastroenterology.


Cytomegalovirus esophagitis in a patient on ocrelizumab therapy: A case report

Ashley A Miller*; Dani Mathew; Charisse Huot

    Infection is the second most common cause of esophagitis, second only to gastroesophageal reflux, and represents a clinically important disorder. Immunosuppressed patients are at highest risk for infectious esophagitis, with candida, herpes simplex virus, and cytomegalovirus being the most common causative microorganisms.


Giardia, 338 years after its discovery: The challenge ahead

Angel A Escobedo*; Emelina Diaz; Caridad Almanza; Pedro Almirall; Luis E Morera; Jhossmar Auza-Santivanez; Susana Terry

    Antony van Leeuwenhoek, the Dutch tradesman who first identified Giardia in 1681, has become a legend in Parasitology. Last November 4th marked the 338th anniversary of the submission of his letter, addressed to Sir Robert Hook, the then Secretary of the Royal Society of London, in which he described his observations in his own faecal sample...


Peutz Jeghers syndrome in pediatric ages: Case presentation

Idalmis Aguilera-Matos*; Sarah E Diaz-Oliva; Frank Perez-Triana; Licet Gonzalez-Fabian; Manuel Lara-Martin

    Peutz Jeghers Syndrome is a rare hereditary polyposis, characterized by the presence of polyps in most cases in the gastrointestinal tract and the presence of very characteristic melanic macules, which lead to periodic monitoring of the entire tract. Gastrointestinal due to the high risk of complications such as bleeding, anemia and intussuspection with concomitant risk of intestinal infarction and subsequent intestinal reception and an increased risk of presenting gastrointestinal and extraintestinal cancer.


The bath gastroscopy toleration score: A validated comfort score for gastroscopy toleration

Emma Saunsbury; Frederica Betteridge; Gordon Taylor; Benjamin Colleypriest*

    Objective: To develop a validated comfort score for gastroscopy
Design: The Bath Gastroscopy Toleration Score (GTS) was developed during routine a gastroscopy list. The score was used by the endoscopist and two nurses to grade the comfort of the patient. During the list the wording of the score was amended and subsequently a consensus between endoscopists and nurses produced the Bath GTS, a five-point scale from 0 – 4 which ascends in terms of patient discomfort....


C-kit expression and potential role of iNOS, COX-2, and ICAM-3 in Giardiasis

Tuba Kara*; Ebru Serinsoz; Rabia Bozdogan Arpaci; Canan Porgali; Gul Emek Yuksek; Yalcın Polat; Gulhan Orekici; Yusuf Usta; Engin Altintas

    Objective: Giardiasis is an intestinal infection and inflammatory mediators take place in host defense mechanisms. The aim of this study was to examine the consistency and usefulness of c-kit in diagnosis, to establish the roles of iNOS, COX-2 and ICAM-3 in the pathogenesis of Giardia Lamblia infection...


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