Tropical gastroenterology : official journal of the Digestive Diseases Foundation最新文献_第10页

Autoimmune Pancreatitis: Unusual Cause of Pancreatic Mass in Children 自身免疫性胰腺炎:儿童胰腺肿块的不寻常原因

Tropical gastroenterology : official journal of the Digestive Diseases Foundation Pub Date : 2020-06-24 DOI: 10.7869/TG.560

P. Sherwani, A. Kaur, Rohan Malik, M. Jana

引用次数: 0

Severe Bisphosphonate Induced Hypocalcaemia in the Background of Severe Necrotizing Pancreatitis due to Primary Hyperparathyroidism. 原发性甲状旁腺功能亢进导致的严重坏死性胰腺炎背景下的严重双膦酸盐诱导的低钙血症。

Tropical gastroenterology : official journal of the Digestive Diseases Foundation Pub Date : 2020-06-24 DOI: 10.7869/TG.559

Anando Sengupta, S. Sharma, K. Das, V. Mittal, P. Kar

{"title":"Severe Bisphosphonate Induced Hypocalcaemia in the Background of Severe Necrotizing Pancreatitis due to Primary Hyperparathyroidism.","authors":"Anando Sengupta, S. Sharma, K. Das, V. Mittal, P. Kar","doi":"10.7869/TG.559","DOIUrl":"https://doi.org/10.7869/TG.559","url":null,"abstract":"Bisphosphonates are pyrophosphate analogues that bind at the bone mineral surface, where they potently inhibit osteoclast-mediated bone resorption. They are used in the treatment of hypercalcemia due to malignancy, osteolytic lesions from multiple myeloma, bone metastasis from solid tumours, osteoporosis, and Paget’s disease. They have also been used effectively in the medical management of primary hyperparathyroidism to decrease serum calcium.1,2 Inhibition of osteoclast activity in bone by bisphosphonates can result in hypocalcaemia and hypophosphatemia. The majority of patients do not manifest hypocalcaemia due to compensatory mechanisms such as raised Parathyroid Hormone (PTH). However, in patients with low Vitamin D levels, renal failure, prior parathyroidectomy, hypomagnesemia, and hypoparathyroidism, these compensatory mechanisms may be blocked, resulting in hypocalcaemia.3-5 Here we report a case in which the use of bisphosphonate for severe hypercalcemia due to primary hyperparathyroidism, led to life-threatening hypocalcaemia. Case Report","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91477429","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}

引用次数: 0

Factors Predicting Peristaltic Abnormalities in Gastroesophageal Reflux 胃食管反流中预测蠕动异常的因素

Tropical gastroenterology : official journal of the Digestive Diseases Foundation Pub Date : 2020-06-23 DOI: 10.7869/TG.556

Piyush Bawane, Mayank Jain, M. Srinivas, T. Michael, J. Venkataraman

{"title":"Factors Predicting Peristaltic Abnormalities in Gastroesophageal Reflux","authors":"Piyush Bawane, Mayank Jain, M. Srinivas, T. Michael, J. Venkataraman","doi":"10.7869/TG.556","DOIUrl":"https://doi.org/10.7869/TG.556","url":null,"abstract":"Background : Data regarding the type of breaks and its impact on peristalsis in gastro esophageal reflux disease(GERD) is scanty. Aim : To study the prevalence and significance of segmental breaks in symptomatic GERD cases. To identify the endoscopy grading and dietary factors that are likely to affect esophageal motility. Materials and Methods : 106 patients with GERD were included. Baseline patient information included age, gender, BMI, diet recall and upper endoscopy report.Normal (Group I) and ineffective swallows (Group II, minor peristaltic defects) were compared for proximal and distal segment breaks . Impact of multiple rapid swallows was assessed in a subset of cases.Appropriate statistical tests were used. p value <0.05 was considered as statistically significant. Results : 72 patients had normal esophageal motility (Group I) and 30 had minor peristalitc abnormality (Group II). BMI was significantly higher in Group II. Mean basal LES pressure, IRP and DCI in Group II was significantly low and a significant proportion of swallows in patients in Group II had breaks greater than 5 cm in S1 and more than 2 cm in S2 and S3. The basal LES pressure and BMI cut off was 12.1 mm Hg and 26.1 kg per m2respectively. The odds ratio of having a minor peristaltic disorder was 3.2 times(1.4-4.1, p 0.001) with the combination of these two factors. Conclusion : Majority of GERD patients had normal motility. Even in those with minor peristaltic abnormality, the peristaltic reserve was good.Patients in group II had significantly lower basal LES pressures and higher BMI.","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88702821","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}

引用次数: 0

Role of Relaxation Therapy In Diarrhea Predominant Irritable Bowel Syndrome 放松疗法在腹泻为主的肠易激综合征中的作用

Tropical gastroenterology : official journal of the Digestive Diseases Foundation Pub Date : 2020-06-23 DOI: 10.7869/TG.553

Pravir A Gambhire, R. Thanage, Ashok R. Mohite, Vinay G. Zanwar, S. Vaidyanathan, Samit Jain, A. Subramanyam, P. Rathi

{"title":"Role of Relaxation Therapy In Diarrhea Predominant Irritable Bowel Syndrome","authors":"Pravir A Gambhire, R. Thanage, Ashok R. Mohite, Vinay G. Zanwar, S. Vaidyanathan, Samit Jain, A. Subramanyam, P. Rathi","doi":"10.7869/TG.553","DOIUrl":"https://doi.org/10.7869/TG.553","url":null,"abstract":"Background: Irritable bowel syndrome (IBS) is a chronic condition. Some patients may benefit from probiotics and rifaximin in diarrhea-predominant IBS (IBS-D). Relaxation therapy has also been tried. Aims and Objectives: To assess the efficacy of rifaximin, VSL#3, and relaxation therapy in IBS-D patients. Methods: 196 patients with IBS-D were randomly assigned to three groups. Group A, B, and C received rifaximin, VSL#3, and relaxation therapy, respectively. Patients were followed up for six months. Results: Relaxation therapy (2.69 ± 0.67) group had significantly improved generalized ill-feeling over VSL# (3.87 ± 0.34) at the end of 6 months. IBS severity score improved in all the groups till the end of the study but relaxation therapy (199.19 ± 30.02) was significantly better than rifaximin (217.21 ± 39.9) and VSL# (250.41 ± 14.78). The subjective global assessment was improved significantly in the relaxation therapy group (2.05 ± 0.9) as compared to rifaximin (3.02 ± 0.85) and VSL#3 (3.84 ± 0.37).. Conclusion: Patients with IBS-D do better with rifaximin and VSL#3 in the short term. Patients respond better to relaxation therapy at the end of 6 months. Relaxation therapy is being a non-pharmacological and cost-effective therapy, could be implemented on a long-term basis.","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78643722","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}

引用次数: 0

The Revised Atlanta Classification is the Strongest Predictor of Mortality in Patients with Acute Pancreatitis: A Study on 358 Patients 修订的亚特兰大分类是急性胰腺炎患者死亡率的最强预测因子:一项对358例患者的研究

Tropical gastroenterology : official journal of the Digestive Diseases Foundation Pub Date : 2020-06-23 DOI: 10.7869/TG.555

S. Anikhindi, Ashish Kumar, Vikas Singla, Praveen Sharma, N. Bansal, N. Verma, A. Arora

{"title":"The Revised Atlanta Classification is the Strongest Predictor of Mortality in Patients with Acute Pancreatitis: A Study on 358 Patients","authors":"S. Anikhindi, Ashish Kumar, Vikas Singla, Praveen Sharma, N. Bansal, N. Verma, A. Arora","doi":"10.7869/TG.555","DOIUrl":"https://doi.org/10.7869/TG.555","url":null,"abstract":"Background: Acute Pancreatitis (AP) presents with a wide range of severity and has varying outcomes. We report our experience with 358 consecutive patients with AP admitted to a tertiary care centre in North India for two years. Methods: In this retrospective study, clinical, biochemical, radiological, and treatment-related data of patients admitted with AP was collected and analysed. Predictors of 120-day mortality and treatment outcomes were analysed. Results: 358 patients (median age 42 years, 78% males) were included. The most common aetiology was biliary (37%) and alcohol (32%). Sixty-nine percent of patients had severe disease at admission according to the revised Atlanta classification. A total of 81 of 358 patients (23%) died within 120 days, with most of the deaths occurring within the first month of illness. A significant proportion of patients having severe AP (74/248, 29.8%) succumbed to illness, while only 6.4% (7/110) patients with mild or moderately severe AP had mortality within 120 days. On multivariate (Cox regression) analysis, the independent factors predicting 120-day mortality were: CT severity index >5 (OR 4.4), presence of respiratory failure (OR 14.9), presence of circulatory failure (OR 4.4), and severe pancreatitis on admission according to revised Atlanta classification (OR 56.4). Conclusions: Biliary and alcohol are the most common aetiologies of acute pancreatitis in north India. Acute pancreatitis still carries a poor outcome with a 23% mortality rate. Patients having severe pancreatitis at admission, according to revised Atlanta classification, are at the highest risk for mortality and should receive intensive care..","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87267522","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}

引用次数: 1

Portal Annular Pancreas: An Underrecognized Variant, Prevalence, and Clinical Relevance 门脉环形胰腺:一种未被充分认识的变异、患病率和临床相关性

Tropical gastroenterology : official journal of the Digestive Diseases Foundation Pub Date : 2020-06-23 DOI: 10.7869/TG.554

R. John, B. Simon, A. Eapen, Tharani Putta, P. Joseph, R. Raju, M. Rymbai, F. Vyas

{"title":"Portal Annular Pancreas: An Underrecognized Variant, Prevalence, and Clinical Relevance","authors":"R. John, B. Simon, A. Eapen, Tharani Putta, P. Joseph, R. Raju, M. Rymbai, F. Vyas","doi":"10.7869/TG.554","DOIUrl":"https://doi.org/10.7869/TG.554","url":null,"abstract":"Background : The portal annular pancreas is a rare morphological variant where the pancreatic parenchyma encircles the portal vein or the superior mesenteric vein and fuses with the body of the pancreas. It may be mistaken for a pancreatic head mass and has grave implications for patients planned for pancreatic surgeries. Aim : This study aimed to determine the prevalence of portal annular pancreas in a cohort of patients attending a tertiary care referral centre in South India and to assess how frequently this was identified and reported in a routine CT scan report. Methods : A retrospective review of consecutive contrast-enhanced multi-detector computed tomography (MDCT) scans of the abdomen during the study period was used to assess for the presence of portal annular pancreas. It was classified into suprasplenic, infrasplenic, and mixed variants based on its relation to the splenoportal confluence. In addition, the radiology reports were reviewed with regard to mention of this variant. Results : The prevalence of portal annular pancreas in our study population was 25 out of 1000 patients (2.5%). There was an increased frequency of this anomaly in females; male: female ratio was 1:2.1. The most common morphological type was suprasplenic fusion. The portal annular pancreas was mentioned in only 1 out of 25 (4%) of the radiology reports. Conclusion : The prevalence of portal annular pancreas was 2.5% with a female preponderance in our series. This entity can be easily overlooked, and increased awareness would improve identification, thereby mitigating complications associated with pancreatic surgery.","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80596796","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}

引用次数: 2

So Near, Yet So Far… 那么近，却又那么远……

Tropical gastroenterology : official journal of the Digestive Diseases Foundation Pub Date : 2020-06-14 DOI: 10.7869/TG.545

A. RajeevS, A. Thomas, N. Ananth, E. Simon

{"title":"So Near, Yet So Far…","authors":"A. RajeevS, A. Thomas, N. Ananth, E. Simon","doi":"10.7869/TG.545","DOIUrl":"https://doi.org/10.7869/TG.545","url":null,"abstract":"Tropical Gastroenterology 104 are the endoscopic treatment of choice for IGV1,2 and GOV2. Endoscopic glue is associated with a significant risk of complications such as embolisation, bleeding, ulceration and extrusion.2-4 Also, it is difficult to see varices properly in the presence of an active bleed or a large blood clot or food residue in the fundus by a conventional gastroscope. Endoscopic ultrasound (EUS) overcomes the limitations of conventional endoscopy. EUS-guided delivery of cyanoacrylate (CYA) glue enables realtime precise delivery of the glue directly into the varix lumen. Moreover, EUS also enables the use of Doppler evaluation to confirm varix obliteration simultaneously. The various EUS-guided therapies used for gastric varices include glue injection, coil placement and combination of both the above. While glue placement carries a risk of embolisation, coils larger than the size of the varix are costly. Thus, a combination of EUS-guided coil and glue decreases the cost (lesser numbers of coils are needed) and reduces the risk of embolisation (lesser amount of glue is needed and the coils act as a scaffold to retain the glue, thereby decreasing the chances of glue embolization). In a retrospective study of 152 patients, EUS-guided combined coil and glue injection of high-risk gastric varices appears to be highly effective for hemostasis in active bleeding and primary and secondary bleeding prophylaxis.5 Once obliteration was achieved, post-treatment bleeding from varices occurred in only 3% of patients during long-term follow-up.5 While asymptomatic glue embolization in the glue-alone group is very common,6 combination therapy appears safe and may reduce the risk of glueembolisation. EUS-guided coil and glue has been shown to be effective in several other studies also.6,7 To summarise, we present a series of 3 cases where endoscopy failed and IR-guided intervention was not possible/feasible. EUS-guided therapy achieved variceal obliteration in all these cases.","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89343785","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}

引用次数: 1

Self-Knotting of the Feeding Jejunostomy Tube: An Extremely Rare Complication 空肠造口管自结:一种极为罕见的并发症

Tropical gastroenterology : official journal of the Digestive Diseases Foundation Pub Date : 2020-06-14 DOI: 10.7869/TG.543

K. Bhatt, Dhaval Mangukiya, P. Desai, Krishna Parekh

引用次数: 0

Gastrointestinal Stromal Tumor of the Anal Canal: An Extreme rarity 肛管胃肠道间质瘤:极为罕见

Tropical gastroenterology : official journal of the Digestive Diseases Foundation Pub Date : 2020-06-14 DOI: 10.7869/TG.548

Monika Gupta, Namita Bhutani, S. Yadav, L. Monga, R. Verma, R. Sen

引用次数: 0

Treatment of the First Severe Attack of Pseudomembranous Colitis with Fecal Microbiota Transplantation 粪便菌群移植治疗首次重症假膜性结肠炎

Tropical gastroenterology : official journal of the Digestive Diseases Foundation Pub Date : 2020-06-14 DOI: 10.7869/TG.546

Prakash Baburao Sonkusare, Pranav Kumar Raghuwanshi, V. Narkhede, Sanjay Kumar

{"title":"Treatment of the First Severe Attack of Pseudomembranous Colitis with Fecal Microbiota Transplantation","authors":"Prakash Baburao Sonkusare, Pranav Kumar Raghuwanshi, V. Narkhede, Sanjay Kumar","doi":"10.7869/TG.546","DOIUrl":"https://doi.org/10.7869/TG.546","url":null,"abstract":"Our patient was a 30 year-old female, who was a diagnosed case of tubercular meningitis (TBM) and was on antitubercular treatment (ATT) for 5 days before she came to us. She was being investigated for fever with headache before being diagnosed as TBM 30 days prior to her presentation and had received multiple oral antibiotics on outpatient basis. She had also been admitted in two different hospitals and received intravenous (IV) antibiotics during that period. She presented with complaints of passage of loose stools 7 to 8 times per day for the last 5 days.The stools were watery in nature and associated with abdominal distension and pain for 3 days, bilateral pedal edema for 3 days and breathlessness for 2 days before admission to this hospital. She was diagnosed with Clostridium difficile (C. difficile) pseudomembranous colitis following a sigmoidoscopy (Figure 1) and a positive stool test for C. difficile toxin. She had an initial leukocyte count of 21360/mm3 with a serum albumin level of 1.3 g/dl and a serum creatinine level of 0.6 mg/dl, thus classifying her as having severe C. difficile colitis. She was started on IV metronidazole and oral vancomycin which was uptitrated to 500 mg every six hours. She continued to have diarrhea even despite 3 days of treatment. She was started on the higher antibiotic, IV Tigecycline, but continued to have abdominal distension and pain, suggesting refractory CDI.1,2 Repeat sigmoidoscopy showed the same picture as earlier without any improvement. Given the severity and refractoriness to the standard antibiotics, a decision to perform fecal microbial transplantation (FMT) was taken on day 6.","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79656767","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}

引用次数: 0