United European Gastroenterology Journal最新文献

{"title":"Acute Food Bolus Impaction Secondary to a Fully Circumferential Inlet Patch.","authors":"Giorgi Kiladze, Wei On, Vivek Goodoory, Björn Rembacken, Peter Ellery","doi":"10.1002/ueg2.70274","DOIUrl":"10.1002/ueg2.70274","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70274"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are ROME Criteria for IBS Useful in Primary Care Practice?","authors":"Niek J de Wit, A Pali S Hungin","doi":"10.1002/ueg2.70289","DOIUrl":"10.1002/ueg2.70289","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70289"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blisters Don't Lie: Celiac Disease in the Skin.","authors":"Jonas F Ludvigsson, Philip Curman","doi":"10.1002/ueg2.70284","DOIUrl":"10.1002/ueg2.70284","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70284"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Course of Portal Hypertension and Its Prognostic Impact After Liver Transplantation.","authors":"Nina Dominik, Petra Dinjar Kujundzic, Sandra Lovrekovic, Hrvoje Premec, Felix Kristandl, Lorenz Balcar, Maja Mijic, Milos Lalovac, Benedikt Silvester Hofer, Lukas Hartl, Christian Sebesta, Georg Kramer, Paul Thöne, Mattias Mandorfer, Michael Trauner, Danko Mikulic, Stipislav Jadrijevic, Georg Györi, Gabriela Berlakovich, Tajana Filipec Kanizaj, Thomas Reiberger","doi":"10.1002/ueg2.70268","DOIUrl":"10.1002/ueg2.70268","url":null,"abstract":"<p><strong>Background: </strong>While portal hypertension (PH) typically resolves after liver transplantation (LT), persistence of PH may affect post-transplant outcomes. We assessed the evolution of PH after LT and its impact on adverse outcomes.</p><p><strong>Methods: </strong>We recorded clinical, laboratory, and imaging parameters of LT recipients between 2016 and 2022 in Vienna and Zagreb. Persistent features of CSPH were defined as the presence of portosystemic collaterals, platelet count (PLT) ≤ 110 G/L, and/or splenomegaly (≥ 13 cm). PH-related clinical events were defined as variceal bleeding, ascites requiring intervention, hepatic hydrothorax, portal vein thrombosis, or liver-related death within 12 months post-LT. Post-LT outcomes were analyzed using landmark Cox regression for 3 months post-LT.</p><p><strong>Results: </strong>Of 645 LT recipients (76% male, median age 59 years) listed with a median MELD of 15 points and PLT of 99 G/L, features of CSPH were present in 537 (83.3%) at baseline. At year 1 after LT, MELD improved to 9 (IQR 7-12), PLT increased to 160 G/L (IQR 120-207), and features of CSPH persisted in 251/453 classifiable patients (55.4%). PH events occurred in 75 (11.6%) and 84 (13%) deaths. In a landmark analysis from 3 months post-LT (n = 521, 29 deaths), persistent thrombocytopenia (< 110 G/L) at M3 independently predicted mortality (aHR 2.31, 95% CI 1.01-5.30, p = 0.048) after adjustment for MELD, age, CRP, and pre-LT TIPS.</p><p><strong>Conclusions: </strong>While PH improves after LT, features of CSPH persisted in 55% of classifiable patients and PH-related clinical events occurred in 11.6% within the first year after LT. Persistent thrombocytopenia (< 110 G/L) at 3 months post-LT independently predicted post-LT mortality (aHR 2.31, 95% CI 1.01-5.30, p = 0.048).</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70268"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acetate- Versus Lactate-Buffered Crystalloids for Prevention of Post-ERCP Pancreatitis in Patients Without Access to Rectal NSAIDs: A Multicentre Double-Blind Randomized Trial.","authors":"Woo Hyun Paik, Gunn Huh, Young Hoon Choi, Jin Ho Choi, In Rae Cho, Sang Hyub Lee, Ji Kon Ryu, Hwa Jung Kim, Taehyung Lee, Ce Hwan Park, Yoonchan Lee, Sung Hyun Cho, Dong-Wan Seo, Kwang Hyuck Lee, Kyu Taek Lee, Jong Kyun Lee, Sunguk Jang, John Vargo, Steven Edmundowicz, Joo Kyung Park, Do Hyun Park","doi":"10.1002/ueg2.70281","DOIUrl":"10.1002/ueg2.70281","url":null,"abstract":"<p><strong>Background: </strong>Aggressive peri-procedural intravenous fluid (IVF) therapy with lactated Ringer's solution (LR) reduces the risk of post-ERCP pancreatitis (PEP), but the standard 8-h protocol is impractical in outpatient settings and the optimal fluid type remains uncertain. We compared LR with an acetate-buffered balanced crystalloid (AC) using a symptom-guided 4-h aggressive IVF protocol.</p><p><strong>Methods: </strong>This multicentre, double-blind, randomized superiority trial was conducted at three academic hospitals in Korea where rectal NSAIDs are unavailable. Adults with native papillae and moderate-to-high PEP risk were randomized to receive LR or AC. The IVF protocol comprised 10 mL/kg boluses before and after ERCP, followed by 3 mL/kg/h for 4 hours and extended to 8 hours if abdominal pain developed or worsened. The primary outcome was PEP incidence; secondary outcomes included early post-ERCP pain and adverse events.</p><p><strong>Results: </strong>Of 813 patients (404 LR, 409 AC), PEP occurred in 12.4% of the LR group and 11.5% of the AC group (relative risk [RR] 0.93; 95% CI, 0.64-1.35; P = 0.70). Rates of mild (7.9% vs. 7.1%) and moderate (4.5% vs. 4.4%) PEP were similar, and no severe PEP or fluid overload occurred. Among the 68.3% of patients who remained asymptomatic at 4 hours and required only 4-h IVF, PEP occurred in 7.4%, with no cases of severe PEP.</p><p><strong>Conclusion: </strong>In this superiority trial, acetate-buffered crystalloid did not reduce PEP compared with lactated Ringer's solution, and no significant safety differences were observed between the two agents. Lactated Ringer's remains the recommended first-line crystalloid for aggressive hydration when rectal NSAIDs are unavailable.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT05832047).</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70281"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cirrhosis Impairs Reconstitution of the Circulating T-Lymphocyte Compartment After Direct-Acting Antiviral Therapy for Hepatitis C Virus Infection.","authors":"Lorena Paule, Elisa Castillo, Leticia Muñoz, Javier Martínez, Carlos Fernández, Alejandro Miranda, Margaret Lario, Jorge Monserrat, Miguel Ángel Ortega, José Luis Calleja, Melchor Álvarez-Mon, Agustín Albillos","doi":"10.1002/ueg2.70250","DOIUrl":"10.1002/ueg2.70250","url":null,"abstract":"<p><strong>Background: </strong>Direct-acting antivirals (DAAs) achieve sustained virological response (SVR) in over 95% of patients with chronic hepatitis C virus (HCV) infection. Although viral eradication allows partial immune restoration, it remains unclear whether established cirrhosis limits recovery of the circulating T lymphocyte compartment after SVR.</p><p><strong>Methods: </strong>We performed a phenotypic and functional analysis of circulating T-helper (Th) and T-cytotoxic (Tc) lymphocytes in patients with chronic HCV infection without fibrosis (HCV-NoF, n = 21) or with cirrhosis (HCV-cirrhosis, n = 20), as well as in alcohol-related cirrhosis (AL-cirrhosis, n = 12) and healthy controls (HC, n = 12). HCV patients were evaluated at baseline and 14 weeks after SVR following DAA therapy. Peripheral blood mononuclear cells were analysed by flow cytometry to quantify T lymphocyte subsets, cytokine production (IFNγ, IL-17), and regulatory T lymphocytes (CD25^high Tregs).</p><p><strong>Results: </strong>HCV infection was associated with marked Tc lymphopenia and selective depletion of naïve Th lymphocytes, regardless of fibrosis stage. These alterations were exacerbated in cirrhosis, particularly in decompensated disease, and closely resembled those observed in AL-cirrhosis. After SVR, HCV-NoF patients showed normalization of Tc counts, redistribution of Tc subsets, and restoration of Th1/Th17 balance and IFNγ/IL-17 profiles. In contrast, HCV-cirrhosis patients exhibited minimal immune recovery, with persistent Th and Tc lymphopenia, sustained depletion of naïve and central memory T lymphocyte subsets, and ongoing inflammatory cytokine skewing. CD25high Treg frequencies increased after SVR in both HCV groups but remained below HC levels, with normalization of chemokine receptor expression occurring only in HCV-NoF patients.</p><p><strong>Discussion: </strong>Cirrhosis profoundly constrains immune reconstitution after HCV cure, limiting post-treatment T-cell recovery.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70250"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Multisystem Comorbidity Patterns in Acute Pancreatitis: Insights From Observational and Genetic Analysis.","authors":"Tianyi Che, Tian Fu, Yuexin Zhu, Xixian Ruan, Yuhao Sun, Jiawei Geng, Lintao Dan, Xiaoyan Wang, Chunhua Zhou, Duowu Zou, Benoit J Arsenault, Shuai Yuan, Xue Li, Zhijie Wang, Xiaofeng Zhang, Jie Chen, Yao Zhang","doi":"10.1002/ueg2.70283","DOIUrl":"10.1002/ueg2.70283","url":null,"abstract":"<p><strong>Introduction: </strong>Acute pancreatitis (AP) is an inflammatory pancreatic disorder with potentially severe systemic consequences. While its immediate clinical impact is well established, the long-term multisystem comorbidities of AP remain underexplored. Clarifying the temporal sequence of these comorbidities is essential for improving patient outcomes.</p><p><strong>Methods: </strong>We conducted a phenome-wide association study (PheWAS) to investigate the associations between AP and 1429 clinical outcomes using Cox proportional hazards models in the UK Biobank. A total of 4767 AP cases were matched 1:10 with controls through birth year, sex, and Townsend deprivation index using incidence density sampling. Disease trajectory analyses were performed to characterize sequential diagnostic patterns of AP-associated comorbidities. Genetic approaches including polygenic risk score analysis, linkage disequilibrium score regression (LDSC), and two-sample Mendelian randomization (TSMR) were used as a genetic triangulation framework to provide complementary evidence for the observational findings and explore shared genetic architecture and potential causal relevance.</p><p><strong>Results: </strong>Over an average follow-up of 13.7 years, AP was associated with 250 incident comorbidities and all-cause death. Three major temporal patterns of AP-related comorbidities were identified, beginning with digestive diseases (e.g., chronic pancreatitis), metabolic and endocrine disorders (e.g., diabetes mellitus), as well as other systemic conditions (e.g., depression). Subsequently, increased risk of organ dysfunction such as myocardial infarction, renal failure, respiratory failure, and then dystrophia, sepsis, septicemia, acidosis followed by all-cause death were observed. The polygenic PheWAS, LDSC, and TSMR analyses provided complementary support for selected associations, including chronic pancreatitis, cyst and pseudocyst of pancreas, duodenal ulcer, diabetes mellitus, anxiety disorder, asthma, and myocardial infarction.</p><p><strong>Conclusions: </strong>This study characterizes long-term multisystem comorbidity patterns associated with AP, highlighting temporal diagnostic patterns linked to adverse outcomes. These findings support the need for multidisciplinary monitoring and targeted interventions to mitigate long-term risks in AP patients.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70283"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Pre-treatment Serum Albumin Concentration Predicts Clinical Benefit of Long-Term Albumin in Patients With Cirrhosis and Ascites\".","authors":"","doi":"10.1002/ueg2.70280","DOIUrl":"10.1002/ueg2.70280","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70280"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Based Detection of Colonic Angiodysplasia Can Improve Endoscopic Reporting Consistency.","authors":"Ioannis Kafetzis, Jana Sophia Theile, Stavros Dimitriadis, Jörg Albert, Wolfram Zoller, Alexander Meining, Alexander Hann","doi":"10.1002/ueg2.70291","DOIUrl":"10.1002/ueg2.70291","url":null,"abstract":"<p><strong>Background and study aims: </strong>Colonic angiodysplasia (AD) is often found incidentally during colonoscopy and frequently omitted from reports, despite being a key cause of lower gastrointestinal bleeding. Artificial intelligence (AI) may improve reporting completeness. In this study, we developed and validated an AI system to support AD documentation.</p><p><strong>Methods: </strong>The system combines a computer vision (CV) model to detect AD in colonoscopy images and videos with a locally deployed open-weight Large Language Model (LLM) to assess whether AD is mentioned in reports. It was externally validated on independent image datasets and prospectively collected videos and used to identify unreported AD cases.</p><p><strong>Results: </strong>The CV model was trained on 10,908 annotated images (986 with AD) from 993 colonoscopies. External validation of 3534 images from 239 procedures showed 94.5% accuracy, 84.4% sensitivity, and 95.9% specificity. The LLM detected AD documentation with 95.8% accuracy, 97.7% sensitivity, and 92.4% specificity. The combined system identified 88 cases where AD was visible but unreported. In 126 full-length videos, 5 cases were physician-reported, while the system detected 23 AD-positive cases.</p><p><strong>Conclusions: </strong>Our AI system accurately detects AD and cross-checks reports, improving documentation completeness and supporting standardized reporting while preserving privacy through local deployment.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70291"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Estimated Intrapancreatic Fat and Its Relationship to Familial and Germline Pancreatic Cancer Risk.","authors":"Tom Konikoff, Laurens P Janssens, Hiroaki Takahashi, Garima Suman, Fred Nugen, Anup Mishra, Panos Korfiatis, Erin E Carlson, William R Bamlet, Aishwarya Pradeep, Kelly Harper, Karen A Doering, Adriana Delgado, Bradley J Erickson, Ajit H Goenka, Naoki Takahashi, Ann L Oberg, Shounak Majumder","doi":"10.1002/ueg2.70279","DOIUrl":"10.1002/ueg2.70279","url":null,"abstract":"<p><strong>Background: </strong>Family history of pancreatic cancer (PC), pathogenic germline variants (PGVs), and increased intrapancreatic fat (IPF) are individually associated with increased PC risk. Whether IPF is elevated in high-risk individuals (HRIs) with PC family history or PGVs is unknown. Although MRI is the preferred modality for IPF measurement, region-of-interest-based approaches are prone to sampling bias because pancreatic fat is heterogeneously distributed. We aimed to compare IPF among HRIs and matched non-HRI controls using an Artificial intelligence (AI)-based tool for whole pancreatic IPF measurement applied to magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>We developed and validated a deep-learning pipeline for IPF measurement that incorporates automated pancreas segmentation on T1-weighted MRI images registered to the corresponding iterative decomposition of water and fat with echo asymmetry and least squares estimation images to compute IPF using proton density fat fraction (PDFF). This pipeline was used to quantify IPF and assess IPF distribution patterns in 85 HRIs and 170 non-HRIs matched 1:2 for age, sex, BMI, and diabetes status. A surface erosion approach was developed to minimize the impact of peripancreatic fat on IPF measurement. Linear models adjusting for matching variables were used to assess associations.</p><p><strong>Results: </strong>Model-expert agreement for whole-pancreas PDFF was excellent (intraclass correlation coefficient 0.99; 95% CI, 0.98-0.99 mean absolute error 1.4%). Mean PDFF did not differ between HRIs and controls (25.8% [11.5] vs. 26.9% [11.4]; p = 0.32). PDFF increased with age (p = 0.015), male sex (p < 0.001), presence of diabetes (p = 0.009), BMI (p < 0.001). IPF distribution patterns did not differ by risk group.</p><p><strong>Conclusion: </strong>An AI-based approach provides accurate, scalable, and objective assessment of IPF quantity and distribution. IPF quantity and spatial distribution do not appear to differ based on germline or familial predisposition to PC.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70279"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}