Digestive Diseases and Sciences最新文献

{"title":"Von Willebrand Disease-Induced Gastrointestinal Bleeding: Report of a Rare Case.","authors":"Bangfa Xiong, Tiansong Fan, Qianfeng Wei, Qian Liu, Erqing Chai","doi":"10.1007/s10620-025-09132-6","DOIUrl":"https://doi.org/10.1007/s10620-025-09132-6","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking and the Bleeding Gut: Impact on 30-Day Readmission with Recurrent Non-variceal Upper GI Hemorrhage.","authors":"Dheeraj Alexander, Mohamed Belal, Mustafa Alnounou","doi":"10.1007/s10620-025-09116-6","DOIUrl":"https://doi.org/10.1007/s10620-025-09116-6","url":null,"abstract":"<p><strong>Background and aims: </strong>Non-variceal upper gastrointestinal bleeding (NVUGIB) is a frequent cause of hospitalization, with significant morbidity and healthcare costs. While non-endoscopic prognostic scores aid in assessing risk, limited data exist on factors influencing 30-day readmissions. Cigarette smoking has been implicated in various gastrointestinal (GI) disorders, yet its role in NVUGIB recurrence remains unclear.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study utilizing the 2021 Nationwide Readmission Database (NRD), analyzing patients with an index admission for NVUGIB. Patients were tracked for 30-day readmission due to recurrent GI bleeding. Cox regression models were employed to identify independent predictors of readmission, including cigarette smoking and other demographic, clinical, and hospital-level factors. The primary outcome was to analyze the effect of cigarette smoking on 30-day readmissions with recurrent upper GI bleeding. Secondary outcomes were readmission mortality rate, length of hospital stay, and total hospitalization charges.</p><p><strong>Results: </strong>Out of 339,444 NVUGIB admissions, 14,247 (4.3%) resulted in 30-day readmission due to recurrent bleeding. In-hospital mortality among readmitted patients was 2.3%. The total length of hospital stay for all patients readmitted within 30 days of discharge was 68,869 days, with resulting total hospitalization charges of $874 million. Cigarette smoking was associated with an increased risk of 30-day readmission (Hazard ratio [HR]: 1.14, 95% CI 1.06-1.23, P = 0.001).</p><p><strong>Conclusion: </strong>This study demonstrates that cigarette smoking is a significant modifiable risk factor for 30-day readmission due to recurrent NVUGIB. These findings underscore the need for targeted smoking cessation interventions to reduce readmission rates and healthcare resource utilization.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-liver Transplant Functional Status: Refining Assessment and Outcomes for MASLD Patients.","authors":"Alberto Ferrarese, Patrizia Burra, Francesco Paolo Russo","doi":"10.1007/s10620-025-09141-5","DOIUrl":"https://doi.org/10.1007/s10620-025-09141-5","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholangioscope-Assisted ERAT: The Light at the End of a Blind Tunnel?","authors":"Sreekanth Appasani, Harsha Vardhan Telaprolu","doi":"10.1007/s10620-025-09095-8","DOIUrl":"https://doi.org/10.1007/s10620-025-09095-8","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps in the Gut: Missed Opportunities for Trauma Screening Before GI Procedures.","authors":"Abigail Bacharach, Yuying Luo","doi":"10.1007/s10620-025-09112-w","DOIUrl":"https://doi.org/10.1007/s10620-025-09112-w","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative Effect of Prior Lesion Manipulation on Colorectal Endoscopic Submucosal Dissection Outcomes: A Retrospective Cohort Study.","authors":"Daryl Ramai, Abdulrahman Qatomah, Hiroyuki Aihara","doi":"10.1007/s10620-025-09102-y","DOIUrl":"https://doi.org/10.1007/s10620-025-09102-y","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic submucosal dissection (ESD) is a minimally invasive technique for en-bloc resection of superficial gastrointestinal lesions. However, the influence of prior manipulations, such as tattooing or endoscopic mucosal resection (EMR), on ESD outcomes is not well understood.</p><p><strong>Methods: </strong>This retrospective cohort study evaluated 763 patients (mean age 64 years, 52% female) who underwent colorectal ESD at Brigham and Women's Hospital between 2014 and 2024. Outcomes included rates of en-bloc, R0, curative resection, and adverse events. Multivariable regression analysis identified factors associated with unsuccessful outcomes.</p><p><strong>Results: </strong>The mean lesion diameter was 50 mm, with 54.4% located in the right colon. Prior tattooing occurred in 7% of cases while prior EMR was reported in 17% of lesions. En-bloc resection was achieved in 95% of cases, R0 resection in 89%, and curative resection in 88%. The mean procedure time was 64 min, with adverse events including delayed bleeding (3.3%), muscle injury (0.9%), and perforation (0.8%). Factors linked to unsuccessful en-bloc resection were prior tattooing (OR 0.30, 95% CI 0.09-0.98; P = 0.047), prior EMR (OR 0.31, 95% CI 0.12-0.82; P = 0.017), and submucosal fibrosis (OR 0.20, 95% CI 0.07-0.53; P = 0.001). Submucosal fibrosis also reduced R0 and curative resection rates. No statistically significant associations between procedural adverse events and fibrosis, prior EMR, or tattooing were found.</p><p><strong>Conclusions: </strong>These findings highlight the importance of avoiding unnecessary pre-procedural manipulations and emphasize the need for urgent planning to optimize ESD outcomes.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemorrhoid, Benign Mass or Malignant Tumor? An Extremely Rare Case of SMARCA4(BRG1)-Deficient Tumor Located in the Perianal Region.","authors":"Zhiyong Mao, Jinchao He, Changfang Xiao, Yan Pan, Qin Qin, Qingjun Dong","doi":"10.1007/s10620-025-09098-5","DOIUrl":"https://doi.org/10.1007/s10620-025-09098-5","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protease Inhibitor VR23 Alleviates Severe Acute Pancreatitis with High Trypsin Synthesis in Mice.","authors":"Junmin Yang, Xiaoyu Yang, Xueyang Li, Jie Liang, Li Zhang, Liang Xia, Jianhua Wan","doi":"10.1007/s10620-025-09103-x","DOIUrl":"https://doi.org/10.1007/s10620-025-09103-x","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis (AP), characterized by pancreatic autodigestion and systemic inflammation, remains a life-threatening condition with a high mortality rate in severe cases. Cholinergic signaling through muscarinic receptors (mAChRs) regulates pancreatic exocrine secretion, yet the role of chronic cholinergic hyperactivation in AP progression is poorly understood. Protease inhibitors like VR23, a potent trypsin-selective compound, hold therapeutic potential but lack evaluation in AP models.</p><p><strong>Objective: </strong>This study aimed to investigate the effects of prolonged cholinergic stimulation on AP severity and evaluate the efficacy of VR23 in mitigating pancreatic injury.</p><p><strong>Methods: </strong>Male C57BL/6 mice were pretreated with intragastric carbachol (5 mg/kg, twice daily for 7 days) to mimic chronic cholinergic hyperactivation, followed by intraperitoneal caerulein (100 μg/kg, 10 hourly doses) to induce AP. VR23 (30 mg/kg) was administered intraperitoneally 12 h and 3 h before caerulein. Pancreatic injury was assessed via histopathology (HE-staining), serum amylase/lipase activity, western blot (trypsin/amylase), RT-qPCR (TNF-α, IL-1β, IL-6, IL-18), MPO immunohistochemistry (neutrophil infiltration), HMGB1 immunohistochemistry (necrosis) and TUNEL staining (apoptosis).</p><p><strong>Results: </strong>Long-term carbachol stimulation induced acinar cell hypertrophy and elevated intracellular trypsin synthesis, exacerbating caerulein-induced AP with increased pancreas-to-body weight ratio, histopathological scores, serum amylase/lipase, and pro-inflammatory cytokines. Neutrophil infiltration and apoptosis were significantly amplified. VR23 pretreatment attenuated pancreatic injury, reducing histopathological scores, serum enzymes, inflammatory cytokines, neutrophil infiltration, and apoptosis.</p><p><strong>Conclusion: </strong>Long-term chronic cholinergic stimulation exacerbates AP by enhancing trypsin synthesis, inflammatory responses, and apoptosis. VR23 demonstrates therapeutic efficacy by inhibiting protease activity and modulating inflammation, highlighting its potential as a targeted treatment for AP.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal Manifestations of Common Variable Immunodeficiency: A Mentored Review.","authors":"Abdillahi Ahmed, William King, Anil Sharma","doi":"10.1007/s10620-025-09106-8","DOIUrl":"https://doi.org/10.1007/s10620-025-09106-8","url":null,"abstract":"<p><strong>Background: </strong>Common variable immunodeficiency (CVID) is an umbrella term for numerous primary immunodeficiency syndromes characterized by B-cell, and sometimes T-cell, impairment. While CVID is commonly associated with recurrent sinopulmonary infections, gastrointestinal (GI) disease-often presenting atypically due to immune dysregulation-can significantly the increase morbidity and mortality of those affected.</p><p><strong>Objectives: </strong>This review summarizes the diagnostic criteria, epidemiology, and GI manifestations of CVID to increase awareness among general practitioners and gastroenterologists. This review may help facilitate prompt diagnosis and treatment of affected patients.</p><p><strong>Methods: </strong>We conducted a narrative review of the literature focusing on the GI manifestations of CVID. This review investigates the GI infections, gastric and bowel diseases, liver involvement, and malignancies associated with this immunodeficiency.</p><p><strong>Results: </strong>There is no universal definition for CVID, but rather several commonly used diagnostic criteria. Patients with CVID are susceptible to GI infections including those caused by Giardia, norovirus, Salmonella, Campylobacter, and cytomegalovirus. Gastric diseases such as atrophic gastritis and pernicious anemia may present atypically. Bowel involvement may include nodular lymphoid hyperplasia, small intestinal bacterial overgrowth, CVID enteropathy, celiac-like disease, and inflammatory bowel-like colitis. Liver involvement can include autoimmune hepatitis, nodular regenerative hyperplasia, and viral hepatitis. In addition, patients with CVID may have a higher incidence of malignancies such as lymphoma and gastric cancer compared to the general population.</p><p><strong>Conclusion: </strong>CVID is associated with a broad spectrum of infectious and noninfectious GI manifestations that can increase the morbidity and mortality of affected patients. Increased awareness of these complications may facilitate earlier diagnosis and effective management.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Post-polypectomy Bleeding After Colorectal Endoscopic Mucosal Resection in Patients with Chronic Kidney Disease: A Propensity-Matched Analysis of the US Collaborative Network.","authors":"Azizullah Beran, Khaled Elfert, Feenalie N Patel, Mouhand Mohamed, Daryl Ramai, Almaza Albakri, Nasir Saleem, Faisal Kamal, Andrew Canakis, Khaled Srour, Danial H Shaikh, Shyam Thakkar, Douglas K Rex, Indira Bhavsar-Burke, John J Guardiola","doi":"10.1007/s10620-025-09122-8","DOIUrl":"https://doi.org/10.1007/s10620-025-09122-8","url":null,"abstract":"<p><strong>Background: </strong>Studies evaluating the risk of post-polypectomy bleeding (PPB) after colorectal endoscopic mucosal resection (EMR) in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) are limited.</p><p><strong>Methods: </strong>This retrospective cohort study utilized the U.S. Collaborative Network to assess the risk of PPB after colorectal EMR in patients with CKD compared to controls. Using one-to-one propensity score matching (PSM), the primary outcome measured was PPB within 30 days after colorectal EMR. The PPB risk was further stratified by CKD severity: non-advanced CKD and advanced CKD.</p><p><strong>Results: </strong>After PSM, each cohort included 9,196 patients. Overall, CKD was associated with increased risk of PPB following colorectal EMR (5.4% vs. 3.8%, odds ratio [OR] 1.44, 95% confidence interval [CI] 1.25-1.66, p < 0.001). The PPB risk was significantly higher in patients with advanced CKD (8.1% vs. 4%, OR 2.09, 95% CI 1.65-2.65, p < 0.001), while those with non-advanced CKD showed modest increase in risk of PPB (4.7% vs. 4%, OR 1.20, 95% CI 1.01-1.41, p = 0.03).</p><p><strong>Conclusion: </strong>Patients with CKD had higher risk of PPB than patients without CKD. The PPB risk was notably increased in patients with advanced CKD. Optimizing patients with CKD, especially advanced CKD, before colorectal EMR and monitoring for post-procedure bleeding remains important.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}