The International Journal of Gastroenterology and Hepatology Diseases最新文献

{"title":"Treatment patterns should be carefully chosen in different primary sites of GI-NECs.","authors":"Hanguang Hu, W. Cai, Jiawei Zhang, Jianshan Mao, Weiting Ge","doi":"10.2174/2666796702666210805104955","DOIUrl":"https://doi.org/10.2174/2666796702666210805104955","url":null,"abstract":"\u0000\u0000Neuroendocrine carcinomas (NECs) are heterogeneous and aggressive in gastrointestinal tract (GI). However, treatment patterns and related outcomes in different primary sites have not been well described.\u0000\u0000\u0000\u0000The SEER data was selected from 2010 to 2016 and 5-year survival was set as the end-point. Coarsened exact matching (CEM) was performed to match comparable patients. Patients were separated by treatment groups and then comparing survivals for treatment patterns used multivariate analysis in different primary sites. \u0000\u0000\u0000\u00003975 patients with GI-NECs including stomach (13.41%), small intestinal (38.82%), colon (25.31%) and rectum (22.47%) were identified. In stomach, primary tumor resection benefits patients (HR=0.492; P= 0.011) in non-metastatic disease and primary surgery combine with systematic chemotherapy (HR=0.401; P= 0.041) benefit patients in metastatic disease comparing with only chemotherapy. In small intestinal, patients’ diagnosis age and tumor size were important factors affecting patients’ overall survival. Primary tumor resection benefits both non-metastatic and metastatic patients (HR=0.246; P= 0.002 vs HR= 0.551; P= 0.005). In colon, primary surgery with systematic chemotherapy benefit patients (HR= 0.633; P= 0.005). In rectum, primary tumor resection benefits non-metastatic patients (HR=0.398; P<0.001), while neither chemotherapy or primary tumor resection showed priority in prolong overall survival in metastatic disease. Pooling all patients received metastatic sites resection and comparing with reference group, metastatic sites resection in GI-NEC will bring survival benefits (HR=0.42; P=0.033).\u0000\u0000\u0000\u0000GI-NECs have different treatment patterns in different primary sites. Primary sites resection should be the basic treatment choices for GI-NECs. Chemotherapy should be cautious especially in non-metastatic patients and considered more clinical and biological characteristics. Patients with distant metastasis can benefit from metastatic site resection.\u0000","PeriodicalId":125135,"journal":{"name":"The International Journal of Gastroenterology and Hepatology Diseases","volume":"196 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114974850","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":"Jejunal Hemolymphangioma in a Patient Presenting with Gastrointestinal Bleeding","authors":"Xiaodong Shao, Le Wang","doi":"10.2174/2666290601666210712102558","DOIUrl":"https://doi.org/10.2174/2666290601666210712102558","url":null,"abstract":"\u0000\u0000Hemolymphangioma is rarely found in the small intestine. There have only been eight reports of hemolymphangiomas arising in the small intestine to date. The first patient was reported by Fang et al.in 2012. A small intestinal hemolymphangioma may lead to anemia and gastrointestinal bleeding.\u0000\u0000\u0000\u0000We report a case of jejunal hemolymphangioma in a 49-year-old man. The patient presented with melena and anemia. He underwent double-balloon enteroscopy (DBE) via the antegrade approach, which demonstrated a 3.0 cm segment of jejunum with nearly 75% of the circumferential lesion with blood remnant. The raised soft lesion was in the middle of the jejunum with white patches on the surface of the mucosa. Endoscopic biopsy was not performed to avoid secondary bleeding. The patient underwent laparotomy, and partial small intestine resection was performed. A 5.0cm segment of jejunum was resected with primary anastomosis. The patient had an uneventful postoperative recovery. Macroscopic pathological examination showed a cavernous, soft and compressible tumor. Microscopic examination showed a tumor that was composed of blood and lymphatic vessels mainly located in the submucosa. The definitive histological diagnosis was jejunal hemolymphangioma. During a follow-up of 2 years, there was no further gastrointestinal bleeding. \u0000\u0000\u0000\u0000Small intestinal hemolymphangioma is a rare benign tumor of which clinical manifestations are nonspecific, and accurate preoperative diagnosis is challenging. Endoscopic biopsy is not recommended for hemolymphangioma of the gastrointestinal tract due to the risk of severe bleeding. Complete surgical resection of the hemolymphangioma is considered the most effective treatment for small intestinal hemolymphangioma.\u0000","PeriodicalId":125135,"journal":{"name":"The International Journal of Gastroenterology and Hepatology Diseases","volume":"198 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122384270","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":"Ectopic Embolism after Endoscopic Glue Injection","authors":"J. Feng, Shixue Xu, Xiaozhong Guo, X. Qi","doi":"10.2174/2666290601666210628161946","DOIUrl":"https://doi.org/10.2174/2666290601666210628161946","url":null,"abstract":"\u0000\u0000A 55-year-old male with a 7-year history of liver cirrhosis was admitted to our department due to recurrent hematemesis and melena. He had been treated with endoscopic tissue glue injection and/or band ligation for gastroesophageal variceal bleeding. He denied any history of viral hepatitis infection or alcohol abuse. At this admission, his pulse rate was 88b.p.m., and blood pressure was 110/51mmHg. Hemoglobin concentration was 81g/L, platelet count was 38X109/L, total bilirubin was 28.4umol/L, and albumin was 24.2g/L. Except for ascites, splenomegaly, and portal vein thrombosis, contrast-enhanced computed tomography scans showed high density within gastric fundal varices, gastro-renal shunt, left renal vein, and inferior vena cava (arrows), suggesting a diagnosis of ectopic embolism from tissue glue injected during a prior endoscopic procedure. Upper gastrointestinal endoscopy demonstrated esophageal varices, post-endoscopic gastric fundal glue removal, and portal hypertensive gastropathy. Esophageal variceal ligation was performed. After that, he was discharged without any other complaints.\u0000\u0000Currently, endoscopic variceal therapy, mainly including variceal band ligation, sclerotherapy, glue injection, and haemostatic powder spraying is the mainstay treatment option of acute variceal bleeding in liver cirrhosis [1]. There is a benefit of endoscopic glue injection for gastric fundal variceal bleeding in terms of increasing the rate of initial hemostasis and reducing the rate of rebleeding as compared to variceal band ligation [2-3]. Therefore, endoscopic glue injection has been widely employed in cirrhotic patients with gastric variceal bleeding. However, there are some severe complications related to endoscopic glue injection [4-5], especially thromboembolism. The current case further showed a possibility of asymptomatic ectopic embolism after endoscopic glue injection, suggesting that a close surveillance of embolism within portosystemic collateral vessels should be necessary.\u0000\u0000\u0000","PeriodicalId":125135,"journal":{"name":"The International Journal of Gastroenterology and Hepatology Diseases","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114025834","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}