Egyptian Liver Journal最新文献

{"title":"Can probiotics play a role in Helicobacter pylori (H. Pylori) eradication?","authors":"Sameh Mohamed Fakhry, Mohamed Abdel-Hameed Kandyl, Adel Ferig Hashish, Wafaa Kandeel, Ahmed Mostafa El-Shenawy, Hoda Samir El-Sayed, Mohamed Kamal Dewidar, Sameh Mohamed Badr, Nayra Shaker Mehanna","doi":"10.1186/s43066-023-00294-4","DOIUrl":"https://doi.org/10.1186/s43066-023-00294-4","url":null,"abstract":"H. Pylori is one of the commonest infectious diseases worldwide. In recent years, PPI-based triple therapy has been described to be losing its efficacy against H. pylori due to high rates of antibiotic resistance, antibiotics-associated side effects, and low compliance. Probiotics are suggested to improve the H. pylori eradication rate when added to H pylori therapy. Probiotics have anti-inflammatory and anti-oxidative mechanisms that may improve bowel microecology and interact with the microbial flora of the gastrointestinal tract to produce a beneficial effect in H Pylori eradication. Probiotics may be also responsible for the reduction of the adverse effects related to H. pylori therapy that may result in treatment failure. In our study, we assessed the role of probiotics in improving the H. Pylori eradication rate and reducing side effects after antibiotic-based therapy. One hundred fifty-nine patients positive for H. pylori stool antigen and had never received previously H. pylori eradication therapy, were included in the study, 59 patients received triple therapy alone (Standard group) and 100 patients received triple therapy and probiotics (study group). One hundred fifty patients completed the treatment. Quantification of Lactobacilli and Bifidobacteria concentration in stool was done by PCR before and after therapy. Eradication of H. pylori was assessed in each group by H. pylori stool antigen after 4 weeks of finishing therapy. H Pylori eradication rate was higher in patients who received probiotics with standard therapy compared to those who received standard therapy alone. The improvement in the eradication rate was statistically significant when probiotics were received after standard therapy (81.04% versus 71.19%, P-Value 0.021). Short-term diarrhea after antibiotics therapy was significantly lower in patients who received probiotics especially when given before antibiotic therapy (7.50% versus 25.50%, P-value 0.0001). Probiotics may play a role to restore gut dysbiosis as evidenced by stool PCR for Lactobacilli and Bifidobacteria before and after therapy. Probiotics have a beneficial role to improve the eradication rate of H. pylori, particularly when given after standard therapy. Adding probiotics was associated as well with less diarrhea as a side effect of antibiotic therapy. The trial has been registered on the Pan African Clinical Trial Register website, No of registration, PACTR202304859303467. Registered 24 April 2023 - Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=25434 .","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"27 8","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138523725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between non-alcoholic fatty liver disease and chronic kidney disease in Egyptian patients","authors":"Heba El Sayed Kasem, Ehab Ahmed Abdelatty, Ahmed Mohamed Mokhtar Yahia, Ezzat Mohamed Abdalla","doi":"10.1186/s43066-023-00297-1","DOIUrl":"https://doi.org/10.1186/s43066-023-00297-1","url":null,"abstract":"NAFLD is a spectrum of disorders ranging from hepatic steatosis to nonalcoholic steatohepatitis (NASH), NASH related cirrhosis and hepatocellular carcinoma (HCC). There is sparse data on the prevalence CKD in Egyptian patients with NAFLD. The aim of this study is to estimate the prevalence of CKD in the subjects with NAFLD and to assess the risk factors of CKD among them. A cross-sectional study was conducted on 430 patients from the Internal Medicine Department, Menoufia University Hospitals, including 215 patients with NAFLD, and 215 patients without NAFLD. NAFLD was diagnosed by abdominal ultrasonography. The liver fibrosis was assessed by NAFLD fibrosis score (NFS) and fibrosis-4 index (FIB-4). CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 and/or abnormal albuminuria (urinary albumin-to-creatinine ratio ⩾ 30 mg/gm). The logistic regression analysis was performed to examine the association between NAFLD and risk of CKD. The prevalence of CKD was higher in individuals with NAFLD than in those without NAFLD (38.1% vs 7.4%, p < 0.001). Logistic regression analysis demonstrated that both NAFLD and CKD were risk factors of each other. The presence of hypertension, high levels of BMI and waist circumference were the other independent risk factors of NAFLD. While the presence of DM, and the high level of BMI were the other significant risk factors of CKD in the NAFLD group. The presence and severity of NAFLD are associated with an increased risk of CKD.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"32 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138542387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alagille syndrome and liver: an adult case report","authors":"Oussama Kharmach, Mohamed Borahma, Fatima-Zohra Ajana","doi":"10.1186/s43066-023-00298-0","DOIUrl":"https://doi.org/10.1186/s43066-023-00298-0","url":null,"abstract":"Abstract Background Alagille syndrome is a rare autosomal-dominant disorder, representing 10 to 15% of the causes of neonatal cholestasis with no gender predominance. The diagnosis is based on the association of liver, heart, eye, skeleton abnormalities, and characteristic facial appearance. Case presentation An 18-year-old male patient, with a family history of benign recurrent intrahepatic cholestasis in a brother, was diagnosed at birth with bile duct paucity. He consulted in adulthood for cholestatic jaundice and pruritus. Physical exam found cutaneous jaundice, particular face, skeletal abnormality of fingers, posterior embryotoxon, and splenomegaly. An echocardiogram found cardiovascular abnormalities. The diagnosis of Alagille syndrome was made in front of five major criteria. A liver biopsy revealed a cirrhosis liver. Upper gastrointestinal endoscopy revealed grade II esophageal varices of portal hypertension. Laboratory tests revealed bicytopenia related to hypersplenism, hypoferritinemia, cytolysis with cholestasis, high bilirubin levels, low prothrombin time, hypoalbuminemia, decreased factor V activity, and hypocholesterolemia. The patient had vitamin K supplementation and was put on ursodeoxycholic acid, propranolol for the liver disease, a high protein hypercaloric diet for malnutrition, vitamin D supplementation and bisphosphonate for the osteoporosis, therapeutic abstention with monitoring for the asymptomatic cardiac disease. After a year of treatment, the patient had an overall health status improvement. Abdominal ultrasound found liver nodules. A biliary MRI showed a multinodular liver. The complement by CT hepatic angiography did not show any nodules while the MRI angiography revealed multiple dysplastic nodules. A liver biopsy was performed and found regenerative nodules. Conclusion The treatment of Alagille syndrome is based on managing the cholestasis and its complications, especially pruritus because it can have a significant impact on quality of life. Due to the complexity of presentation and multi-organ involvement, management of cases with Alagille syndrome should be done by a multidisciplinary team. Liver disease is responsible for morbidity while cardiac disease is a mortality risk factor in this population.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"11 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135042012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complexities in liver biopsy: the role of navigation and fusion imaging","authors":"Serah Jessy Mathew, Anchal Nayak, Sagnika Dash, Sarada Prasad Dakua","doi":"10.1186/s43066-023-00293-5","DOIUrl":"https://doi.org/10.1186/s43066-023-00293-5","url":null,"abstract":"Abstract Liver biopsy is crucial to know if the tumor is benign or malignant. This paper has reviewed the literature clinically shedding lights on the present biopsy procedure, requirements, and potential challenges. This study has emphasized the role of navigation during liver biopsy. It has discussed the various imaging modalities used for biopsy. The potential limitations of imaging modalities have been discussed in detail. It is found that liver biopsy could be effective when fusion imaging is used instead of a single imaging modality.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"8 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135868959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic variceal ligation in primary and secondary prevention of variceal bleeding: a retrospective study in Digestive Endoscopy Unit, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar","authors":"Chantelli Iamblaudiot Razafindrazoto, Nitah Harivony Randriamifidy, Jolivet Auguste Rakotomalala, Sedera Radoniaina Rakotondrasoa, Behoavy Mahafaly Ralaizanaka, Henintsoa Rakotoniaina, Antsa Fihobiana Randrianiaina, Mialitiana Rakotomaharo, Domoina Harivonjy Hasina Laingonirina, Sonny Maherison, Anjaramalala Sitraka Rasolonjatovo, Andry Lalaina Rinà Rakotozafindrabe, Tovo Harimanana Rabenjanahary, Soloniaina Hélio Razafimahefa, Rado Manitrala Ramanampamonjy","doi":"10.1186/s43066-023-00295-3","DOIUrl":"https://doi.org/10.1186/s43066-023-00295-3","url":null,"abstract":"Abstract Introduction Endoscopic variceal ligation (EVL) is a crucial procedure for the primary and secondary prevention of variceal bleeding. The objective of this study was to evaluate the efficacy and tolerability of EVL in the prevention of variceal bleeding. Methods This was a retrospective, single-center study over 8 years, from January 2013 to December 2020, including all patients who came for EVL in primary or secondary prevention. Results Fifty-seven patients (male/female: 39/18) were included. The mean age of the patients was 40.02 ± 12.32 years (range: 19–68). Portal hypertension was secondary to cirrhosis in 13 patients (22.8%) and to a non-cirrhotic cause in 44 patients (77.2%). EVL was indicated for primary and secondary prevention in 5.3% and 94.7%, respectively. All patients had received propranolol with a mean daily dose of 108.07 ± 38.52 mg (extremes: 80–160). Eradication of varices was achieved in 33 patients (57.9%) with an average of 3.06 ± 0.70 sessions (extremes: 1–5) and an average duration of 10.12 ± 6.21 months (extremes: 1–24). Ten patients (17.5%) had variceal bleeding, and one patient (1.8%) died. There was no significant difference between patients with cirrhotic and non-cirrhotic portal hypertension in terms of varices eradication, variceal bleeding, and mortality. Gender ( HR : 37.18; CI : 0.14–18.4; p = 0.009) and the number of previous bleeds ( HR : 1.34; CI : 1.01–1.80; p = 0.041) were independent predictors of variceal bleeding during EVL. Dysphagia (73.7%) and retrosternal pain (78.9%) were the main adverse events after ligation. Conclusion EVL is an efficient technique to eradicate varices. Its tolerance is good with post-ligation signs that are rapidly regressive.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"347 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135863510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of pancreatic branch duct-type intraductal papillary mucinous neoplasms (BD-IPMNs) after surgery for extrapancreatic malignancies","authors":"Akira Imoto, Takeshi Ogura, Daisuke Masuda, Ken Narabayashi, Toshihiko Okada, Yosuke Abe, Toshihisa Takeuchi, Takuya Inoue, Kumi Ishida, Sadaharu Nouda, Kazuhide Higuchi, Usama M. Abdelaal","doi":"10.1186/s43066-023-00286-4","DOIUrl":"https://doi.org/10.1186/s43066-023-00286-4","url":null,"abstract":"Abstract Background/aims The natural history of pancreatic branch duct-type intraductal papillary mucinous neoplasms (BD-IPMNs) is still unknown. This retrospective study aims to determine the morphological changes of BD-IPMNs with attention to the history of surgical resection for extrapancreatic malignancies. Methods and materials This study included 427 subjects with BD-IPMN at the Osaka Medical College from January 2001 to December 2019; 134 patients were included. The predictive factors for the progression of BD-IPMN based on morphological changes were evaluated by univariate as well as multivariate analyses. Furthermore, the clinical features of BD-IPMNs with progressive lesions during follow-up were investigated. Results The average interval of follow-up was 35.8 months (with a range between 12.1 and 157 months). Disease progression occurred in 6 subjects (4.5%). In two of them (1.5%), IPMN-related invasive carcinoma was found. Multivariate analysis demonstrated that surgical resection for extrapancreatic malignancies was a significant predictor of BD-IPMN progression. Conclusion The history of resection of extrapancreatic malignancies should be considered during the follow-up of BD-IPMN.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"31 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135113274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between BDNF gene polymorphisms and alcohol-related liver cirrhosis","authors":"Danil I. Peregud, Valeria Yu. Baronets, Anna S. Lobacheva, Alexandr S. Ivanov, Irina V. Garmash, Olga S. Arisheva, Zhanna D. Kobalava, Sergey V. Pirozhkov, Natalia N. Terebilina","doi":"10.1186/s43066-023-00296-2","DOIUrl":"https://doi.org/10.1186/s43066-023-00296-2","url":null,"abstract":"Abstract Background and aim Brain-derived neurotrophic factor (BDNF) functions not only in the brain but also in peripheral tissues such as the liver. Genetic factors determine the development of alcohol dependence and somatic consequences of chronic intoxication, especially liver cirrhosis. The BDNF gene polymorphisms are associated with alcohol dependence; however, their relationship with the development of alcohol-related liver cirrhosis (ALC) has not yet been established. This study evaluated the association between single-nucleotide polymorphisms (SNPs) within the BDNF gene and liver cirrhosis in heavy drinkers. Methods BDNF-related SNPs rs925946, rs6265, rs10835210, rs7103411, and rs75945125 were determined using real-time PCR in heavy drinkers with and without liver cirrhosis. Single SNPs and defined haplotypes within the BDNF gene were tested for association with ALC. Results According to both codominant and recessive genetic models, carriers of the rs925946 TT genotype have an elevated risk of liver cirrhosis development with odds ratios (confidence intervals) 6.287 (1.286–30.738) and 6.321 (1.317–30.348), respectively. BDNF SNPs rs6265, rs10835210, rs7103411, and rs75945125 do not associate with risk of ALC. One block of haplotypes consisting of rs10835210 and rs7103411 demonstrated linkage disequilibrium ( D ′ = 1 and r 2 = 0.228). The revealed haplotypes do not associate with the development of liver cirrhosis in alcohol heavy drinkers. Conclusion Thus, the BDNF rs925946 SNP is associated with the risk of ALC in heavy drinkers. Future investigations of the BDNF gene-related genetic markers of ALC will help to objectively assess the risk and severity of liver damage and correct the corresponding therapy.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135217073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life and its determinants among South Indian type 2 diabetes patients with and without non-alcoholic fatty liver disease","authors":"Usha Sree Puneem, Vanitha Rani Nagasubramanian, Vasudeva Murthy Sindgi, Subburaya Mudaliyar Rajendran Ramakrishnan, Ranakishor Pelluri","doi":"10.1186/s43066-023-00288-2","DOIUrl":"https://doi.org/10.1186/s43066-023-00288-2","url":null,"abstract":"Abstract Background and aims Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease in type-2 diabetics. The quality of life among those patients was not explored well. Hence, the present study aimed to correlate the determinants with the quality of life (QoL) among the study subjects. Methods A hospital-based case–control study was conducted at Bhargavi Gastro and Surgical Hospital, Warangal, Telangana, with 358 subjects, from 1 November 2019 to 31 October 2021 (24 months). A 358 of cohort type-2 diabetes mellitus (T2DM) subjects were recruited with 1:1 of NAFLD and without NAFLD. QoL was determined with the SF-36 questionnaire, which comprises eight domains. Statistical analysis included t test, chi-square, and Spearman correlation performed with SPSSV.25 software. Results Out of 358 subjects, 200 (55.8%) were males and 158 (44.1%) were females. Glycemic parameters (FBS and HbA1c), lipid profile, liver transaminases (SGPT and SGOT), and serum uric acid levels were significantly high in NAFLD subjects ( p < 0.05). The SF-36 score, four domains (physical, energy, mental health, and pain) are significantly reduced in NAFLD subjects p < 0.05). A significant correlation between blood urea and impaired physical, emotional mental, and general health was observed in NAFLD subjects. In the NAFLD subjects, elevated FBS levels lead to impairment of physical and emotional status. Social functioning, general health, and pain were impaired with BMI and TG levels in NAFLD subjects. The mean, SD of SF-36 scores showed no significant difference in contrast to HbA1c among both groups ( p > 0.05). Conclusion The decreased QoL was observed in subjects of T2DM with NAFLD. The QoL is significantly influenced by elevated FBS, SGPT, SGOT, and TG levels. Hence, clinicians need to be vigilant and implement strategies to improve the quality of life in type 2 diabetics with NAFLD.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136013553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of serum resistin level and Il-6 as prognostic biomarkers of decompensated liver cirrhosis in chronic hepatitis C virus patients","authors":"Ayman F. El-Shayeb, Akram A. Degheidy, Sawsan El-Mallah, John Farid, Amany N. Abbasy","doi":"10.1186/s43066-023-00268-6","DOIUrl":"https://doi.org/10.1186/s43066-023-00268-6","url":null,"abstract":"Abstract Background Decompensated liver cirrhosis (DLC) is now known as a chronic inflammatory process, evidenced by elevated levels of circulatory pro-inflammatory cytokines and chemokines which in turn lead to the development of more hepatic decompensation and multi-organ failure. Resistin has a pro-inflammatory effect through the production of several cytokines (e.g., IL-1, IL-6, IL-12, and TNF-α) and cell adhesion molecules. Interleukin-6 (IL-6) is a proinflammatory cytokine playing a crucial role in acute phase responses and in regulating immune reactions through activation and differentiation of T and B lymphocytes. The current study aimed to evaluate the value of serum resistin and IL-6 as biomarkers of DLC and their role as prognostic markers of complications in these patients. Results This study was conducted on 90 patients divided into three groups: group I—30 patients with compensated cirrhosis (CLC); group II—40 patients with DLC; and group III consisted of 20 healthy controls. Serum resistin and IL-6 levels were statistically significantly higher in patients with DLC compared to patients with CLC at baseline. A cut-off value of &gt; 302 pg/ml for serum resistin was found to discriminate between CLC and DLC with a specificity of 73.33% and sensitivity of 92.50% and a cut-off level of &gt; 31 pg/mL for IL-6 differentiated between the two groups with a sensitivity of 85.0% and specificity of 76.67%. Patients with DLC were followed up for 3 months, 10 patients (25%) passed away, and 19 patients out of the remaining 30 (63.3%) patients developed complications including acute kidney injury, spontaneous bacterial peritonitis, variceal hemorrhage, encephalopathy, and hepatocellular carcinoma. Serum resistin and IL-6 were found to be significantly higher at baseline in those patients who developed complications or mortality after the follow-up period. In addition, there were positive correlations between IL-6 and resistin and MELD-NA and CRP. Conclusion Serum resistin and IL-6 could be used as sensitive diagnostic and prognostic biomarkers of decompensated cirrhotic patients.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare gastrointestinal bleeding due to a cholecystoduodenal fistula: a case report","authors":"Maddalena Zippi, Antonella Toma, Wandong Hong, Sirio Fiorino, Alfonso Grottesi","doi":"10.1186/s43066-023-00292-6","DOIUrl":"https://doi.org/10.1186/s43066-023-00292-6","url":null,"abstract":"Abstract Background Gastrointestinal bleeding from cholecystoduodenal fistula is rare. It is usually managed surgically, although a conservative approach is reported in isolated cases. Case presentation A 71-year-old male patient was admitted to the emergency department (ED) presenting melena associated with severe anemia, requiring a blood transfusion. An urgent upper endoscopy showed the intestinal orifice of a cholecystoduodenal fistula. This finding was confirmed by radiological examination and laparoscopy. Cholecystectomy and simultaneous excision of the fistula were successfully performed. As a result, a diagnosis of Mirizzi syndrome type Va was also made. Conclusion A cholecystoduodenal fistula orifice leading to gastrointestinal bleeding is difficult to diagnose without an endoscopic examination of the upper digestive tract. Following this first diagnostic step, a comprehensive patient examination should be conducted, specifically if a history of gallbladder lithiasis has been reported.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136211334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}