Ajith Thomas, Anand Vimal Dev, Anoop John, Reetu Amrita John, Lalji Patel, Reuben Thomas Kurien, Anu Eapen, Ebby George Simon, Amit Kumar Dutta, Rajeeb Jaleel, Anjilivelil Joseph Joseph, Sudipta Dhar Chowdhury
{"title":"The effectiveness of a conservative approach in the management of groove pancreatitis.","authors":"Ajith Thomas, Anand Vimal Dev, Anoop John, Reetu Amrita John, Lalji Patel, Reuben Thomas Kurien, Anu Eapen, Ebby George Simon, Amit Kumar Dutta, Rajeeb Jaleel, Anjilivelil Joseph Joseph, Sudipta Dhar Chowdhury","doi":"10.1007/s12664-024-01715-x","DOIUrl":"https://doi.org/10.1007/s12664-024-01715-x","url":null,"abstract":"<p><strong>Background: </strong>Groove pancreatitis (GP) is a form of pancreatitis that affects the pancreaticoduodenal groove area, which lies between the head of the pancreas, the second part of the duodenum and the distal bile duct, presenting as abdominal pain and gastric outlet obstruction. In this study, we present the clinical and radiological characteristics of individuals diagnosed with groove pancreatitis at our center and discuss the use of a conservative treatment approach in managing GP.</p><p><strong>Methods: </strong>The data of patients with groove pancreatitis treated at our center between January 2012 and December 2021 was analyzed. The clinical, laboratory and radiological features were recorded and patients were followed up for at least six months in the pancreatic clinic by a specialist doctor.</p><p><strong>Results: </strong>Fifty patients were included in the study. Most patients were males (98%) in the middle age group (35 to 55 years) (70%) with chronic alcohol use and/or smoking noted in 48 (96%) of them. Ninety-six per cent presented with recurrent abdominal pain. The most common imaging features were the thickening of the medial duodenal wall (100%) followed by enhancement of the scar tissue in the groove (98%). All patients were initially treated conservatively with advice to abstain from addictions, of whom 35 patients were followed up. Twenty per cent of the patients (seven out of 35) did not respond and required a step-up approach with endoscopic retrograde cholangiopancreatography (for biliary obstruction), celiac block (for ongoing abdominal pain) and surgery (gastrojejunostomy for gastric outlet obstruction, Frey's procedure for abdominal pain). Most patients were asymptomatic at follow-up (mean follow-up of 30 months).</p><p><strong>Conclusion: </strong>The diagnosis of GP continues to be a challenge. A step-up approach appears to be a reasonable strategy in managing GP as most of them can be managed conservatively.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004779","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":"Hereditary pancreatitis with a N29I mutation in the PRSS1 (Trypsinogen) gene: A case report from India.","authors":"Merlyn Rodrigues, Priyanka Mattela, Rupjyoti Talukdar, Chandan Peddapulla, Sundeep Lakhtakia, Mitnala Sasikala, Nageshwar Reddy Duvvur, Ravikanth Vishnubhotla","doi":"10.1007/s12664-024-01722-y","DOIUrl":"https://doi.org/10.1007/s12664-024-01722-y","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004778","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":"Pre-emptive underwater coagulation of large blood vessels during POEM.","authors":"Zaheer Nabi, Pradev Inavolu, Rajesh Goud, Santhosh Darisetty, D Nageshwar Reddy","doi":"10.1007/s12664-024-01731-x","DOIUrl":"https://doi.org/10.1007/s12664-024-01731-x","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983412","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 symptoms and disorders of gut-brain interaction in pregnancy.","authors":"Abhinav Jain, Shraddha Ramchandani, Shobna Bhatia","doi":"10.1007/s12664-024-01705-z","DOIUrl":"https://doi.org/10.1007/s12664-024-01705-z","url":null,"abstract":"<p><p>Gastrointestinal (GI) symptoms occur frequently in pregnant women, resulting in poor quality of life. These patients frequently require co-management with the obstetrician and a physician/GI specialist. The causation is complex and multifactorial. It is a result of a combination of maternal changes in pregnancy and feto-placental hormonal effects on the GI tract (the feto-placental-gut axis). Additional factors such as the gut-brain interaction, genetics, immune response and effects of maternal supplements during pregnancy also contribute to the causation of symptoms. The most common of these symptoms include nausea and vomiting followed by heartburn. The common lower GI symptoms include constipation and hemorrhoids. Irritable bowel syndrome (IBS) is also common in a pregnant patient. But there is a paucity of literature and high-quality studies concerning the management of IBS. This review addresses the pathophysiology and clinical and laboratory evaluation of the common upper GI and lower GI symptoms and their management. A majority of symptoms are mild and lifestyle modifications with non-pharmacological measures should be the first-line management, whereas drugs should be used judiciously in case of non-response or severe symptoms. The nutritional status of the mother and the fetus needs close monitoring. Drugs that are routinely used in pregnancy are discussed with regard to the safety of the mother and the fetus. GI endoscopy may be needed in select patients and the indications for endoscopy and colonoscopy in pregnancy along with special pregnancy-related precautions are discussed. Most symptoms improve to pre-pregnancy state after delivery.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926983","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":"Unusual appearance of hepatic cavernous hemangioma on ultrasound in a patient with fatty liver.","authors":"Divij Agarwal, Sunil Taneja, Pankaj Gupta","doi":"10.1007/s12664-024-01710-2","DOIUrl":"https://doi.org/10.1007/s12664-024-01710-2","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872068","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":"EUS-guided biliary drainage in patients with malignant biliary obstruction with total gastrectomy status: Jejunum to rescue.","authors":"Ramesh Uddarraju, Jimmy Narayan, Anuraag Jena, Girish Kumar Pati, Manjit Kanungo, Swarup Patnaik, Vasista Palnati","doi":"10.1007/s12664-024-01713-z","DOIUrl":"https://doi.org/10.1007/s12664-024-01713-z","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854016","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":"ABC score is a better predictor for 30-day mortality in upper gastrointestinal bleeding: A prospective single-center study.","authors":"Vikas Pemmada, Athish Shetty, Shiran Shetty, Ganesh Pai C, Balaji Musunuri, Siddheesh Rajpurohit, Ganesh Bhat","doi":"10.1007/s12664-024-01703-1","DOIUrl":"https://doi.org/10.1007/s12664-024-01703-1","url":null,"abstract":"<p><strong>Background: </strong>Acute upper gastrointestinal bleeding (UGIB) still has a mortality rate of about 10%. Several pre-endoscopy scoring systems have been developed to predict the outcome, but none accurately predict mortality. The present study was aimed at comparing the new ABC score (age, blood tests and comorbidities) with other pre-existing scoring systems to predict mortality.</p><p><strong>Methods: </strong>This prospective single-center study was done at a tertiary hospital in India in 2022-2023. Patients > 18 years presenting with UGIB within 48 hours were included in the study. They were divided into variceal and non-variceal UGIB cohorts and were followed for 30 days after receiving standard-of-care treatment.</p><p><strong>Results: </strong>Out of 296 patients, 168 (56.7%) had variceal (V) bleed, while 128 (43.2%) individuals had a non-variceal (NV) type of GI bleed. The mortality rate was 9.8% (n = 29), which was higher among the V bleed group compared to the NV bleed group (8.7% vs. 1.1%). The area under the receiver operating characteristics (AUROC) for ABC score was the highest (0.75) compared to other scoring systems and was also more significant among deaths related to V bleed (0.76) than NV bleed (0.64). Hypoalbuminemia and > 3 blood transfusions are significant factors in predicting mortality.</p><p><strong>Conclusion: </strong>Our study demonstrates that the ABC score is superior to other scores in predicting 30-day mortality in patients with UGIB. ABC score may be a better predictor of mortality among V bleed patients than NV bleeds.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854008","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}