Gastroenterology & Endoscopy最新文献

{"title":"Diagnostic efficacy of computed tomography angiography for acute gastrointestinal bleeding","authors":"Joseph Atarere ,&nbsp;Thilini Delungahawatta ,&nbsp;Boniface Mensah ,&nbsp;Ramya Vasireddy ,&nbsp;Ted O. Akhiwu ,&nbsp;Yakubu Bene-Alhasan ,&nbsp;Sarah Rimm ,&nbsp;Jose Mari Parungao ,&nbsp;Dana Sloane ,&nbsp;Christopher Haas ,&nbsp;David Weisman ,&nbsp;Haider Naqvi","doi":"10.1016/j.gande.2025.03.004","DOIUrl":"10.1016/j.gande.2025.03.004","url":null,"abstract":"<div><h3>Background and aims</h3><div>Computed tomography angiography (CTA) is the radiologic test for acute gastrointestinal bleeding (GIB). We aimed to (1) identify the clinical factors associated with (a) positive CTA findings, (b) positive esophagogastroduodenoscopy (EGD) findings after a negative CTA, and (2) compare bleeding severity on EGD by CTA findings.</div></div><div><h3>Methods</h3><div>Using data from a retrospective cohort of patients, we examined the factors associated with positive CTA findings and those associated with bleeding on EGD after a negative CTA. We examined the severity of upper GIB on EGD by findings on CTA and compared bleeding severity with the Glasgow Blatchford Score (GBS). We also evaluated the factors associated with high-grade bleeding lesions on EGD.</div></div><div><h3>Results</h3><div>A total of 1677 patients were included in this study, of which 229 (13.7 ​%) had positive CTA findings. A history of GIB, hematochezia on presentation and any length of stay in the ICU were associated with positive CTA findings. Among patients with negative CTA results, hematemesis on presentation [OR 2.94; 95 ​% CI (1.53, 5.64)] and high-risk GBS [OR 5.19; 95 ​% CI (2.02, 13.35)] were associated with finding upper GIB on EGD. ICU admission for 4+ days was associated with higher-grade bleeding lesions. Those with positive CTA findings had a higher proportion of Forrest 1 lesions (10.8 ​% vs 3.7 ​%).</div></div><div><h3>Conclusion</h3><div>Our findings support a low threshold for EGD among patients with extended ICU stays (4+ days) even after a negative CTA. The GBS, validated for risk stratification in upper GIB, remains a useful predictive tool even in the context of a negative CTA.</div></div>","PeriodicalId":100571,"journal":{"name":"Gastroenterology & Endoscopy","volume":"3 2","pages":"Pages 116-124"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonic diagnosis of hepatic and splenic infarction: A case report","authors":"Ting Zhang,&nbsp;Huaping Jia","doi":"10.1016/j.gande.2025.03.001","DOIUrl":"10.1016/j.gande.2025.03.001","url":null,"abstract":"<div><div>It is extremely rare for both the liver and spleen to experience infarction simultaneously. Hepatic and splenic infarction is a severe condition, and early diagnosis has a significant impact on the prognosis. This article reports a case of a 62-year-old male with hepatic and splenic infarction. Ultrasound examination revealed abnormal hypoechoic regions in the parenchyma of the liver and spleen, and there was no blood perfusion in the lesion area. Enhanced CT further confirmed the presence of hepatic and splenic infarction.</div></div>","PeriodicalId":100571,"journal":{"name":"Gastroenterology & Endoscopy","volume":"3 2","pages":"Pages 105-107"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated liver segmentation from CT images using modified ResUNet","authors":"R.V. Manjunath ,&nbsp;Yashaswini Gowda N ,&nbsp;H.M. Manu","doi":"10.1016/j.gande.2025.03.002","DOIUrl":"10.1016/j.gande.2025.03.002","url":null,"abstract":"<div><div>The Segmentation of liver from computed tomography (CT) images is a critical task in medical research particularly when employing deep learning methods. Most doctors prefer to use Computed tomography images for liver disease identification hence automatic liver segmentation plays a decisive role. To perform automatic segmentation of liver popular architectures such as modified ResUNet are specifically designed to capture multi-resolution features. In this study we proposed an automatic system that utilizes convolutional layers to efficiently extract features while maintaining spatial information. A modified Residual UNet model was developed for liver segmentation using the 3Dircadb dataset, the model demonstrated excellent performance by achieving a Dice Score of <strong>93.08 ​%</strong>, accuracy of 98.57 ​%, Jaccard Index of 87.12 ​%, a volumetric overlap error of 12.87 ​%, and a relative volume difference of 14.91 ​% on 128x128 size images. These results highlight the effectiveness of the proposed method. The primary goal of this research is to apply deep learning techniques for liver segmentation and assess the model's performance using segmentation metrics.</div></div>","PeriodicalId":100571,"journal":{"name":"Gastroenterology & Endoscopy","volume":"3 2","pages":"Pages 93-104"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extensive recurrence of colon adenocarcinoma: A case of cutaneous metastasis to the legs and its clinical implication","authors":"Jeffrey Baum ,&nbsp;Adeline Fleitz ,&nbsp;Charles Sticco","doi":"10.1016/j.gande.2025.02.002","DOIUrl":"10.1016/j.gande.2025.02.002","url":null,"abstract":"<div><div>The rate of cutaneous metastases in cancer patients overall is reported at highly variable rates, presenting in up to 5% of visceral malignancies. Colorectal carcinoma most commonly metastasizes to lymph nodes, lung, liver, and peritoneum, with only 2–6% metastasizing to the skin.^1,2,3 While cutaneous metastasis of colorectal cancer most commonly spreads to the surgical scar site, metastasis to the legs, however, is exceedingly rare and only a handful of case reports are recorded in the literature.^3,4,5 Early diagnosis of cutaneous metastases is critical, yet remains challenging, as a full body skin exam is not typically included in routine colon cancer surveillance. Here, we present a patient who was found to have recurrent colon adenocarcinoma with metastasis to the bilateral thighs. Our case, highlights the importance of conducting a thorough skin examination as part of routine colon cancer surveillance.</div></div>","PeriodicalId":100571,"journal":{"name":"Gastroenterology & Endoscopy","volume":"3 2","pages":"Pages 90-92"},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal adenocarcinoma with unexpectedly high AFP levels: A diagnostic challenge","authors":"Rida Inam ,&nbsp;Asim Mehmood ,&nbsp;Eshan Ahmad ,&nbsp;Hazar Khan ,&nbsp;Usama Shafiq ,&nbsp;Eesha Rizwan","doi":"10.1016/j.gande.2025.02.001","DOIUrl":"10.1016/j.gande.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Alpha-fetoprotein (AFP)-producing Esophageal Adenocarcinoma (EAC) is an extremely rare entity with only a few cases reported till date. Reporting the first case of AFP producing EAC from Pakistan.</div></div><div><h3>Case presentation</h3><div>A 41-year-old male who presented with pain in epigastrium, vomiting, and dysphagia. On investigations, he was found to have an AFP-producing EAC with a surprisingly high AFP level of 60,500 ng/mL.</div></div><div><h3>Conclusion</h3><div>Our case report highlights that apart from being a marker of Hepatocellular Carcinoma (HCC), AFP levels can sometimes increase in other tumors like EAC. With the diagnosis being really challenging due to its rarity. It is an aggressive tumor which usually presents late when the tumor has already metastasized to other organs and has a poor prognosis. Proper treatment regimen and regular follow ups with AFP levels should be done to keep a track of progress and recurrence of tumor.</div></div>","PeriodicalId":100571,"journal":{"name":"Gastroenterology & Endoscopy","volume":"3 2","pages":"Pages 86-89"},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol-associated liver disease: A review","authors":"Damarla Nagarjuna,&nbsp;Elumalai Karthikeyan","doi":"10.1016/j.gande.2025.01.003","DOIUrl":"10.1016/j.gande.2025.01.003","url":null,"abstract":"<div><div>Alcohol-associated Liver Disease (ALD) is a collection of liver disorders caused by prolonged and excessive alcohol consumption, ranging from fatty liver alterations to fibrosis and cirrhosis. This condition accounts for 5.9 ​% of all annual fatalities, making it a significant contributor to the global disease burden. The pathophysiology of ALD involves various processes, such as abnormal alcohol metabolism, inflammation, oxidative stress, and disrupted lipid metabolism. Risk factors for ALD include obesity, metabolic syndrome, hepatitis, smoking, and sex, with women being more susceptible to liver damage at lower levels of alcohol consumption. To prevent advanced ALD and promote recovery, prompt intervention and alcohol abstinence are essential. However, diagnosing ALD can be challenging owing to the lack of early symptoms, emphasising the need for effective and accessible treatments. Current treatments for ALD focus on symptomatic management and liver transplantation in end-stage cases. However, the limited number of donors and the requirement for alcohol abstinence before transplantation pose significant challenges. Understanding the molecular mechanisms underlying ALD is crucial for the identification and development of novel therapeutic strategies. This review aims to provide an overview of the pathophysiology, diagnosis, and treatment of ALD, highlighting the critical need for further research and interventions to address this global health threat.</div></div>","PeriodicalId":100571,"journal":{"name":"Gastroenterology & Endoscopy","volume":"3 2","pages":"Pages 65-85"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colorectal cancer spectrum: From subtypes and epidemiology to oncotherapies","authors":"Nidhi Agrawal,&nbsp;S.K. Lanjhiyana,&nbsp;Meenakshi Jaiswal,&nbsp;Mohammad Akbar Siddiqui,&nbsp;Sakshi Gupta","doi":"10.1016/j.gande.2025.01.002","DOIUrl":"10.1016/j.gande.2025.01.002","url":null,"abstract":"<div><div>Colorectal cancer (CRC) has an incidence rate of 10 ​% and is the third most common cause of mortality worldwide, following breast and lung cancer. The clinical symptoms of CRC appear in the last phases of the disease and there is a substantial golden period between the formation of polyps and the onset of cancer. There are many traditional options available for the treatment of CRC, such as surgery, chemotherapy, radiation therapy, etc. Although there have been significant advancements in conventional therapies, the management and prevention of CRC are still relatively challenging due to disease reoccurrence and resistance to chemotherapy. Recently, novel strategies including targeted therapy and immunotherapy have emerged as novel possibilities for treating CRC. The present article provides an overview of the molecular subtypes, epidemiology, carcinogenesis, risk factors, diagnostic approaches, and recent advancements in therapeutic options for the treatment of CRC.</div></div>","PeriodicalId":100571,"journal":{"name":"Gastroenterology & Endoscopy","volume":"3 2","pages":"Pages 55-64"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic immune-inflammation index: Unveiling the diagnostic potential in ulcerative colitis through a comprehensive systematic review and meta-analysis","authors":"Anas Elgenidy ,&nbsp;Omar Alomari ,&nbsp;Tasbih Emad ,&nbsp;Sara K. Kamal ,&nbsp;Islam E. Al Ghanam ,&nbsp;Aya Sherif ,&nbsp;Mohammed Al-mahdi Al-kurdi ,&nbsp;Abdallah A. Helal ,&nbsp;Yusof Mohamed Omar ,&nbsp;Mohamed Rafiek Ramadan","doi":"10.1016/j.gande.2024.10.003","DOIUrl":"10.1016/j.gande.2024.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Ulcerative colitis (UC) is a chronic inflammatory bowel disease with unpredictable colon and rectum inflammation episodes. Evaluating disease activity is essential for effective management. The systemic immune-inflammation index (SII) is a potential biomarker for assessing inflammation and disease severity in UC. This meta-analysis aims to comprehensively assess the utility of SII in UC by analyzing its association with disease activity.</div></div><div><h3>Methods</h3><div>PubMed, Scopus, Embase, Cochrane, and Web of Science databases have been searched for relevant studies OpenMetaAnalyst software were utilized in the analysis. Furthermore, we conducted a diagnostic test accuracy (DTA) analysis using Meta-Disc version 2.0 software, employing a univariate model to assess the sensitivity, specificity, and predictive value of SII.</div></div><div><h3>Results</h3><div>We included seven retrospective studies comprising 1127 UC patients and 686 healthy controls. Our analysis revealed a significantly higher SII in UC patients compared to healthy controls (mean difference: −620.00, 95 ​% CI -1337.08 – 97.07), indicating its potential as a diagnostic marker. SII was also significantly lower in UC patients in remission compared to those with active disease (mean difference: −521.71, 95 ​% CI -962.92 to −80.50), suggesting its role in monitoring disease activity. The DTA analysis demonstrated a pooled sensitivity of 0.622 and specificity of 0.805 for SII in predicting UC activity, with a diagnostic odds ratio of 6.773.</div></div><div><h3>Conclusion</h3><div>Our meta-analysis reveals that the SII holds significant promise as a non-invasive marker for assessing the activity and severity of UC. The findings demonstrate that SII is significantly lower in healthy controls compared to UC patients and lower in patients in remission compared to those with active disease.</div></div>","PeriodicalId":100571,"journal":{"name":"Gastroenterology & Endoscopy","volume":"3 1","pages":"Pages 22-31"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcutaneous panniculitis as complication of valproate-induced pancreatitis","authors":"Michel Tawk,&nbsp;Salim Salloum,&nbsp;Radwan Zeidan,&nbsp;Mirna Fares","doi":"10.1016/j.gande.2024.10.001","DOIUrl":"10.1016/j.gande.2024.10.001","url":null,"abstract":"<div><div>Medications and drugs constitute a well-known etiology of pancreatitis. Rare signs and symptoms of the disease can occur. We present a case of pancreatitis caused by valproic acid and that was complicated by subcutaneous panniculitis.</div></div>","PeriodicalId":100571,"journal":{"name":"Gastroenterology & Endoscopy","volume":"3 1","pages":"Pages 36-38"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of hemobilia caused by acute cholecystitis with an underlying gallbladder aneurysm","authors":"Hui Yi Sara Cheo ,&nbsp;En Xian Sarah Low ,&nbsp;Wee Ming Tay","doi":"10.1016/j.gande.2024.11.001","DOIUrl":"10.1016/j.gande.2024.11.001","url":null,"abstract":"<div><div>We present a case of a patient who presented with upper gastrointestinal bleeding, obstructive jaundice and bacteremia, of which the underlying cause turned out to be hemobilia from acute cholecystitis and a gallbladder aneurysm. The patient made a full recovery after laparoscopic cholecystectomy. Our case highlights the importance of having a high index of suspicion for hemobilia and showcases how hemobilia can be a rare cause of persistent obstructive jaundice.</div></div>","PeriodicalId":100571,"journal":{"name":"Gastroenterology & Endoscopy","volume":"3 1","pages":"Pages 32-35"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}