Gastroenterology: Medicine & Research最新文献

{"title":"A Case Report of Spontaneous Pneumoperitoneum","authors":"S. Bradulskis","doi":"10.31031/gmr.2019.02.000546","DOIUrl":"https://doi.org/10.31031/gmr.2019.02.000546","url":null,"abstract":"","PeriodicalId":130011,"journal":{"name":"Gastroenterology: Medicine & Research","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129746399","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":"Inflammatory Bowel Disease, Ulcerative Colitis, Crohns Disease or Indeterminate Colitis? Diagnostic Challenge","authors":"Neeraj Nagaich, Radha Sharma, Niranjana Nair","doi":"10.31031/gmr.2019.02.000545","DOIUrl":"https://doi.org/10.31031/gmr.2019.02.000545","url":null,"abstract":"Usually diffuse disease, but may show rectal sparing Toxic dilation may be present Morphological Microscopic Features Seen in Indeterminate Colitis Extensive ulceration with a sharp transition to normal adjacent mucosa. Transmural lymphoid inflammation, with an absence of lymphoid aggregates. Absence of well-defined, epithelioid granulomas distant from crypts. Multiple squat V-shaped ulcers, lacking surrounding inflammation.","PeriodicalId":130011,"journal":{"name":"Gastroenterology: Medicine & Research","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132060110","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":"Gastrointestinal Diseases in Pregnancy; Diagnosis and Management","authors":"Neeraj Nagaich, Radha Sharma, Niranjana Nair","doi":"10.31031/GMR.2019.02.000544","DOIUrl":"https://doi.org/10.31031/GMR.2019.02.000544","url":null,"abstract":"","PeriodicalId":130011,"journal":{"name":"Gastroenterology: Medicine & Research","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125588104","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":"Outcome of living donor liver transplantation in patients of hepatic malignancy with metachronous adrenal gland metastasis: Can we achieve long term survival?","authors":"A. Thorat, S. Hsu, Horng-ren Yang, T. Chen, K. Poon, Ping-chun Li, L. Jeng","doi":"10.31031/gmr.2018.02.000541","DOIUrl":"https://doi.org/10.31031/gmr.2018.02.000541","url":null,"abstract":"Hepatocellular carcinoma (HCC) is third most frequent cause of cancer-related deaths worldwide. Liver transplantation (LT) is a potentially curative treatment and is the best treatment option for patients with decompensated cirrhosis. Although advanced HCCs are considered as contraindication for LT due to dismal prognosis, certain patients of HCCs with solitary metastasis in adrenal gland without any other extra-hepatic disease can still be managed by local resection of the adrenal gland metastasis and sequential LT. Herein we present our experience of sequential 4 cases of HCC solitary metastasis to adrenal gland that were treated by local resection followed by LT. Materials and Methods: Database of 937 patients that underwent LT at china medical university hospital was retrospectively analyzed. Four HCC patients that had solitary adrenal metastasis were evaluated for the outcome after living donor liver transplantation (LDLT). Three patients were diagnosed to have HCC whereas one patient was diagnosed with unresectable cholangiocarcinoma on explant pathology. All the four patients had underlying cirrhosis with solitary adrenal metastasis without any extrahepatic spread of primary disease. The adrenal gland metastasis was confirmed by pre-LT PET scan. Results: Four patients (mean age, 53 years; M:F, 2:2) underwent LDLT for HCC with single adrenal metastasis (right adrenal gland=2 patients; and left adrenal gland=2 patients) . In three patients the adrenalectomy was performed during the recipient surgery whereas one patient underwent LDLT six months after the adrenal metastasis resection (Table 1). Follow up period ranged from 9 months to 59 months. Survival in first two patients was 52 and 59 months, respectively. The first patient developed lung metastatic and expired due to overwhelming sepsis at 52nd post-LT month. The second patient in this series continue to have recurrence free survival at 59 months post-LT. The survival in third and fourth patients was 28 months and 9 months, respectively. The fourth patient in addition had mixed HCC-cholangiocarcinoma on histopathological analysis. Conclusion: Limited extrahepatic metastasis due to HCC can still be resected and LT can be performed if liver resection not possible with a good overall survival. The adrenalectomy can be done as a single stage procedure during LT surgery without increasing the risk.","PeriodicalId":130011,"journal":{"name":"Gastroenterology: Medicine & Research","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114176640","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":"Prevention of Incisional Hernia: What is new?","authors":"D. Sharma","doi":"10.31031/GMR.2018.02.000542","DOIUrl":"https://doi.org/10.31031/GMR.2018.02.000542","url":null,"abstract":"Incisional hernia (IH) is among the commonest post-operative complication after midline laparotomy. In spite of all technological advances its incidence remains 5-26%; prompting surgeons to think about IH prevention techniques. A scrutiny of factors associated with IH clearly shows that most of these are patient related and are beyond the Surgeon’s control. However, there are a few Surgeon-related preventive measures which can help in bringing down the incidence of IH. These include efforts directed at reducing surgical site infection, preferred use of laparoscopy over conventional open surgery, preferred use of transverse incision, using current recommendations for midline laparotomy closure, incisional reinforcement in high risk groups by prophylactic mesh, special incisions/ techniques for prevention of IH in special circumstances, identification of high-risk cases and their centralized care, and increasing awareness of safety of synthetic mesh in presence of infection and strangulation. This brief review is based on relevant published literature in ‘PubMed’ and ‘Google Scholar’ since 2013. Now that it is possible to identify high risk patients for development of IH, high quality evidence is available for its prevention and the preventive measures do not require expansive resources; time has come to convert available knowledge to implementation.","PeriodicalId":130011,"journal":{"name":"Gastroenterology: Medicine & Research","volume":"144 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129381320","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":"Primary Sclerosing Cholangitis: A Diagnostic and Management Dilemma!","authors":"Mohammad Maaz Razi, M. Mirza, Sadia Reaz, K WaleedHussain, K. Mumtaz","doi":"10.31031/GMR.2018.02.000540","DOIUrl":"https://doi.org/10.31031/GMR.2018.02.000540","url":null,"abstract":"","PeriodicalId":130011,"journal":{"name":"Gastroenterology: Medicine & Research","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116494224","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":"3D Laparoscopy: A Potential Cutting Edge in Minimal Invasive Digestive Surgery","authors":"S. Sibio, S. Carlo, G. Sica","doi":"10.31031/GMR.2018.02.000539","DOIUrl":"https://doi.org/10.31031/GMR.2018.02.000539","url":null,"abstract":"Laparoscopic surgery has changed surgical landscape, providing reduced surgical trauma, shorter hospital stays, less postoperative pain and better outcomes than open surgery. Since its first development in the 90’s, 3D technology applied to laparoscopic surgery has had several technical improvements and now it represents, together with high definition technology, the best option in minimal invasive digestive surgery, providing shorter operative times and lower blood loss, making easier to perform surgical tasks both for trainees than for skilled surgeons. It remains a little bit more expensive than standard 2D laparoscopic devices but even cheaper than robotic equipment. Gastro Med Res Copyright © Simone Sibio 2/3 How to cite this article: Simone S, Sara di C, Giuseppe S S. 3D Laparoscopy: A Potential Cutting Edge in Minimal Invasive Digestive Surgery. Gastro Med Res. 2(3). GMR.000539. 2018. DOI: 10.31031/GMR.2018.02.000539 Volume 2 Issue 3 laparoscopy with regards to performance time. The results for the experimental trials showed predominantly an improvement in time and a reduction in number of errors with 3D laparoscopy. The experimental setting does not reflect the complexity of clinical conditions and this could explain why neither operative time nor decrease in errors were reported in other clinical trials [20]. However, results from our initial experience with 3d laparoscopy on 95 patients (55 colorectal resections, 32 cholecystectomies, 5 gastrectomies, 3 distal pancreatectomies) showed that use of 3d device in most common digestive surgical procedures carry shorter operative time and lower blood loss, although complications, hospital stay and conversion rates, as well as hospital expenses do not change by using 3d rather than 2d laparoscopy [21]. These results are confirmed by those of a recent large metanalysis including 21 studies (13 retrospective and 8 randomized trials) which analyzed existing experiences on several similar digestive surgical procedures (cholecystectomy, appendectomy, gastric resections, colorectal resections, hepatectomy, oesophagectomy) [16,20,22,23]. As reported in available papers in literature, 3D vision seems to offer technical advantages in deep surgical fields, for vessel identification and ligation and in the accuracy of surgical manipulation as a result of the increased depth perception [18,20,24]. Currently, conclusive evidences that analyze the comparative efficacy of tridimensional laparoscopy remain in scarcity. Sorensen et al. [23] performed a systematic review of 3D laparoscopy vs 2D laparoscopy on simulated settings. Their results merely revealed a better performance on surgical tasks and trainings by tridimensional laparoscopy. By far, larger scale randomized trials on this topic are still lacking and no consensus has been reached among current literature. The main results, regarding comfort for the surgeon, have been investigated in simulated settings that have shown a better depth perception, han","PeriodicalId":130011,"journal":{"name":"Gastroenterology: Medicine & Research","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131615131","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 Case of Helicobacter Pylori-Negative Gastric- MALT Lymphoma, Disseminated to the Small bowel, Colon, and Lung","authors":"M. Kantor, Monica L. Multani, N. Patel, J. Gascon, J. Sobrado, C. Marin","doi":"10.31031/gmr.2018.02.000537","DOIUrl":"https://doi.org/10.31031/gmr.2018.02.000537","url":null,"abstract":"Extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (EMZL-MALT) have been linked to chronic immune stimulation due to infection or autoimmune stimuli. Helicobacter pylori induced gastric MALT lymphoma is the most extensively documented and well understood. However, in those where H. pylori is not detected, data is less established. Its treatment and prognosis are based on histological evaluation, immunophenotyping, and the use of fluorescence in situ hybridization (FISH), or polymerase chain reaction (PCR) to identify chromosomal translocation and/or unbalanced aberrations. The most common chromosomal translocation with pathogenic significance is t (11;18) (q21:q21). Those patients presenting with this translocation tend to have more advanced disseminated disease and are likely resistant to conventional antibiotic therapy and certain chemotherapeutic agents. Synchronous MALT lymphoma and overt distant dissemination has rarely been reported. We report a case of a 71-year-old female with biopsy confirmed H. pylori negative-gastric MALT lymphoma with disseminated disease involving the stomach, small intestine, colon, and lung. FISH analysis was positive for BIRC-3-MALT1 (11;18) fusion protein. Finally, we issue a call-to-action for much needed further data to establish clear treatment options based on clinical and diagnostic criteria, for extra-gastric, disseminated, and/or H. pylori negative MALT lymphomas. .","PeriodicalId":130011,"journal":{"name":"Gastroenterology: Medicine & Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131226095","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":"Differential Diagnosis of Pancreatic Cyst Tumors","authors":"Solonitsyn Eg","doi":"10.31031/gmr.2018.02.000536","DOIUrl":"https://doi.org/10.31031/gmr.2018.02.000536","url":null,"abstract":"Pancreatic cystic neoplasm is a group of neoplastic changes in the epithelium of the ducts or parenchyma of the pancreas. This is a complex diagnostic problem of modern medicine. With the improvement of diagnostic methods for pancreatic pathology, the frequency of detection of incidental pancreatic cysts has been increased. Some cystic lesions neoplasms are recognized as precursor of pancreatic adenocarcinoma and requires early surgical treatment, or close observation. The article discusses the issues of classification, the malignant potential and the differential diagnosis of pancreatic cysts. fluids. Cytological sensitivity is low SCN is a thin-walled cystic tumor with a microcystic component not connected with the pancreatic duct. EUS-FNA shows a bright, clear fluid with a low level of amylase, tumor markers and negative for mucin. The sensitivity of cytological study is low. SPN is a tumor with solid and cystic components, which is found mainly in young women (20-30 years old). EUS-FNA shows hemorrhagic fluids, with a low level of amylase, and negative staining for mucin. The diagnosis can be made as a result of morphological study of aspirate.","PeriodicalId":130011,"journal":{"name":"Gastroenterology: Medicine & Research","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128488216","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":"Exercise and Sarcopenia in Cirrhosis","authors":"J. Soldera, Anderson Rech, Danusa Rossi","doi":"10.31031/GMR.2018.02.000532","DOIUrl":"https://doi.org/10.31031/GMR.2018.02.000532","url":null,"abstract":"Cirrhosis is the end stage of every chronic liver disease, which leads to fibrosis and inflammation, resulting in a compromise of the structure and function of the liver [1]. Cirrhosis can cause a collapse of liver histology, modifying the vascular architecture of the organ and increasing the risk of cancer [2]. Besides the obvious consequences regarding the physiological function of the liver, cirrhosis might affect other tissues indirectly, like the muscular tissue. These patients might present a sensible loss of muscular mass, leading to clinically significant sarcopenia [3,4].","PeriodicalId":130011,"journal":{"name":"Gastroenterology: Medicine & Research","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124771659","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}