World Journal of Gastrointestinal Endoscopy最新文献

{"title":"Polyposis found on index colonoscopy in a 56-year-old female - <i>BMPR1A</i> variant in juvenile polyposis syndrome: A case report.","authors":"Michael Yulong Wu,&nbsp;Christopher Toon,&nbsp;Michael Field,&nbsp;May Wong","doi":"10.4253/wjge.v15.i10.623","DOIUrl":"https://doi.org/10.4253/wjge.v15.i10.623","url":null,"abstract":"<p><strong>Background: </strong>Juvenile polyposis syndrome (JPS) is a rare hereditary polyposis disease frequently associated with an autosomal-dominant variant of the <i>SMAD4</i> or <i>BMPR1A</i> gene. It often manifests with symptoms in children and adolescents and is infrequently diagnosed in asymptomatic adults. Establishing the diagnosis is important as patients with JPS have a high risk of developing gastrointestinal cancer and require genetic counselling and close routine follow-up.</p><p><strong>Case summary: </strong>We report on the case of a 56-year-old female diagnosed with JPS after genetic testing revealed a rare variant of the <i>BMPR1A</i> gene <i>BMPR1A c.1409T>C</i> (p.Met470Thr). She was initially referred for colonoscopy by her general practitioner after testing positive on a screening faecal immunochemical test and subsequently found to have polyposis throughout the entire colorectum on her index screening colonoscopy. The patient was asymptomatic with a normal physical examination and no related medical or family history. Blood tests revealed only mild iron deficiency without anemia. To date, there has only been one other reported case of JPS with the same genetic variant. Subsequent colonoscopies were organised for complete polyp clearance and the patient was returned for surveillance follow-up.</p><p><strong>Conclusion: </strong>JPS patients can present with no prior symptoms or family history. Genetic testing plays an important diagnostic role guiding management.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 10","pages":"623-628"},"PeriodicalIF":2.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10600688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transoral outlet reduction: Outcomes of endoscopic Roux-en-Y gastric bypass revision in 284 patients at a community practice.","authors":"Daniel B Maselli,&nbsp;Vibhu Chittajallu,&nbsp;Chase Wooley,&nbsp;Areebah Waseem,&nbsp;Daniel Lee,&nbsp;Michelle Secic,&nbsp;Lauren L Donnangelo,&nbsp;Brian Coan,&nbsp;Christopher E McGowan","doi":"10.4253/wjge.v15.i10.602","DOIUrl":"https://doi.org/10.4253/wjge.v15.i10.602","url":null,"abstract":"<p><strong>Background: </strong>Transoral outlet reduction (TORe) is a minimally invasive endoscopic revision of Roux-en-Y gastric bypass (RYGB) for weight recurrence; however, little has been published on its clinical implementation in the community setting.</p><p><strong>Aim: </strong>To characterize the safety and efficacy of TORe in the community setting for adults with weight recurrence after RYGB.</p><p><strong>Methods: </strong>This is a retrospective cohort study of argon plasma coagulation and purse-string suturing for gastric outlet reduction in consecutive adults with weight recurrence after RYGB at a single community center from September 2020 to September 2022. Patients were provided longitudinal nutritional support <i>via</i> virtual visits. The primary outcome was total body weight loss (TBWL) at twelve months from TORe. Secondary outcomes included TBWL at three months and six months; excess weight loss (EWL) at three, six, and twelve months; twelve-month TBWL by obesity class; predictors of twelve-month TBWL; rates of post-TORe stenosis; and serious adverse events (SAE). Outcomes were reported with descriptive statistics.</p><p><strong>Results: </strong>Two hundred eighty-four adults (91.9% female, age 51.3 years, body mass index 39.3 kg/m²) underwent TORe an average of 13.3 years after RYGB. Median pre- and post-TORe outlet diameter was 35 mm and 8 mm, respectively. TBWL was 11.7% ± 4.6% at three months, 14.3% ± 6.3% at six months, and 17.3% ± 7.9% at twelve months. EWL was 38.4% ± 28.2% at three months, 46.5% ± 35.4% at six months, and 53.5% ± 39.2% at twelve months. The number of follow-up visits attended was the strongest predictor of TBWL at twelve months (R² = 0.0139, <i>P</i> = 0.0005). Outlet stenosis occurred in 11 patients (3.9%) and was successfully managed with endoscopic dilation. There was one instance of post-procedural nausea requiring overnight observation (SAE rate 0.4%).</p><p><strong>Conclusion: </strong>When performed by an experienced endoscopist and combined with longitudinal nutritional support, purse-string TORe is safe and effective in the community setting for adults with weight recurrence after RYGB.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 10","pages":"602-613"},"PeriodicalIF":2.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10600692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gallbladder plication as a rare complication of endoscopic sleeve gastroplasty: A case report.","authors":"Cesar D Quiroz Guadarrama,&nbsp;Luis Andres Saenz Romero,&nbsp;Eric Misael Saucedo Moreno,&nbsp;Martín E Rojano Rodríguez","doi":"10.4253/wjge.v15.i10.629","DOIUrl":"https://doi.org/10.4253/wjge.v15.i10.629","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic sleeve gastroplasty (ESG) is a minimally invasive procedure used in the treatment of obesity, with a complication rate of less than 2% of cases. There have been only two reported cases worldwide of gallbladder injuries as a major complication of ESG.</p><p><strong>Case summary: </strong>We present the case of a 34-year-old patient who developed a complication after ESG. The patient experienced epigastric and right hypochondrium pain 12 h after the procedure, and a positive Murphy's sign was identified on physical examination. Laboratory results showed a leukocyte count of 17 × 10³/µL, and computed tomography indicated the presence of free fluid in the pelvic cavity and perihepatic recesses as well as a possible suture in the wall of the Hartmann's pouch toward the anterior surface of the stomach. A diagnostic laparoscopy was performed, revealing plication of the Hartmann's pouch wall to the anterior stomach wall. Laparoscopic cholecystectomy and lavage were carried out. The patient had a stable recovery and was discharged 72 h after surgery, tolerating oral intake.</p><p><strong>Conclusion: </strong>Gallbladder plication should be suspected if signs and symptoms consistent with acute cholecystitis occur after ESG.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 10","pages":"629-633"},"PeriodicalIF":2.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10600689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graft dilatation and Barrett's esophagus in adults after gastric pull-up and jejunal interposition for long-gap esophageal atresia.","authors":"Eleonora Sofie van Tuyll van Serooskerken,&nbsp;Gabriele Gallo,&nbsp;Bas L Weusten,&nbsp;Jessie Westerhof,&nbsp;Lodewijk Aa Brosens,&nbsp;Sander Zwaveling,&nbsp;Jetske Ruiterkamp,&nbsp;Jan Bf Hulscher,&nbsp;Hubertus Gm Arets,&nbsp;Arnold Jn Bittermann,&nbsp;David C van der Zee,&nbsp;Stefaan Haj Tytgat,&nbsp;Maud Ya Lindeboom","doi":"10.4253/wjge.v15.i9.553","DOIUrl":"https://doi.org/10.4253/wjge.v15.i9.553","url":null,"abstract":"<p><strong>Background: </strong>Esophageal replacement (ER) with gastric pull-up (GPU) or jejunal interposition (JI) used to be the standard treatment for long-gap esophageal atresia (LGEA). Changes of the ER grafts on a macro- and microscopic level however, are unknown.</p><p><strong>Aim: </strong>To evaluate long-term clinical symptoms and anatomical and mucosal changes in adolescents and adults after ER for LGEA.</p><p><strong>Methods: </strong>A cohort study was conducted including all LGEA patients ≥ 16 years who had undergone GPU or JI between 1985-2003 at two tertiary referral centers in the Netherlands. Patients underwent clinical assessment, contrast study and endoscopy with biopsy. Data was collected prospectively. Group differences between JI and GPU patients, and associations between different outcome measures were assessed using the Fisher's exact test for bivariate variables and the Mann-Whitney <i>U</i>-test for continuous variables. Differences with a <i>P</i>-value < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>Nine GPU patients and eleven JI patients were included. Median age at follow-up was 21.5 years and 24.4 years, respectively. Reflux was reported in six GPU patients (67%) <i>vs</i> four JI patients (36%) (<i>P</i> = 0.37). Dysphagia symptoms were reported in 64% of JI patients, compared to 22% of GPU patients (<i>P</i> = 0.09). Contrast studies showed dilatation of the jejunal graft in six patients (55%) and graft lengthening in four of these six patients. Endoscopy revealed columnar-lined esophagus in three GPU patients (33%) and intestinal metaplasia was histologically confirmed in two patients (22%). No association was found between reflux symptoms and macroscopic anomalies or intestinal metaplasia. Three GPU patients (33%) experienced severe feeding problems <i>vs</i> none in the JI group. The median body mass index of JI patients was 20.9 kg/m² <i>vs</i> 19.5 kg/m² in GPU patients (<i>P</i> = 0.08).</p><p><strong>Conclusion: </strong>The majority of GPU patients had reflux and intestinal metaplasia in 22%. The majority of JI patients had dysphagia and a dilated graft. Follow-up after ER for LGEA is essential.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 9","pages":"553-563"},"PeriodicalIF":2.0,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d1/c3/WJGE-15-553.PMC10514707.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41145512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Ruler for varix size measurement: A multicenter pilot study.","authors":"Yi-Fei Huang,&nbsp;Sheng-Juan Hu,&nbsp;Yang Bu,&nbsp;Yi-Ling Li,&nbsp;Yan-Hong Deng,&nbsp;Jian-Ping Hu,&nbsp;Shao-Qi Yang,&nbsp;Qian Shen,&nbsp;Mark McAlindon,&nbsp;Rui-Chun Shi,&nbsp;Xiao-Qin Li,&nbsp;Tie-Ying Song,&nbsp;Hai-Long Qi,&nbsp;Tai-Wei Jiao,&nbsp;Meng-Yuan Liu,&nbsp;Fang He,&nbsp;Jun Zhu,&nbsp;Bin Ma,&nbsp;Xiao-Bin Yu,&nbsp;Jian-Yang Guo,&nbsp;Yue-Hua Yu,&nbsp;Hai-Jiang Yong,&nbsp;Wen-Tun Yao,&nbsp;Ting Ye,&nbsp;Hua Wang,&nbsp;Wen-Fu Dong,&nbsp;Jian-Guo Liu,&nbsp;Qiang Wei,&nbsp;Jing Tian,&nbsp;Xiao-Guo Li,&nbsp;Xavier Dray,&nbsp;Xiao-Long Qi","doi":"10.4253/wjge.v15.i9.564","DOIUrl":"https://doi.org/10.4253/wjge.v15.i9.564","url":null,"abstract":"<p><strong>Background: </strong>We invented Endoscopic Ruler, a new endoscopic device to measure the size of varices in patients with cirrhosis and portal hypertension.</p><p><strong>Aim: </strong>To assess the feasibility and safety of Endoscopic Ruler, and evaluate the agreement on identifying large oesophageal varices (OV) between Endoscopic Ruler and the endoscopists, as well as the interobserver agreement on diagnosing large OV using Endoscopic Ruler.</p><p><strong>Methods: </strong>We prospectively and consecutively enrolled patients with cirrhosis from 11 hospitals, all of whom got esophagogastroduodenoscopy (EGD) with Endoscopic Ruler. The primary study outcome was a successful measurement of the size of varices using Endoscopic Ruler. The secondary outcomes included adverse events, operation time, the agreement of identifying large OV between the objective measurement of Endoscopic Ruler and the empirical reading of endoscopists, together with the interobserver agreement on diagnosing large OV by Endoscopic Ruler.</p><p><strong>Results: </strong>From November 2020 to April 2022, a total of 120 eligible patients with cirrhosis were recruited and all of them underwent EGD examinations with Endoscopic Ruler successfully without any adverse event. The median operation time of Endoscopic Ruler was 3.00 min [interquartile range (IQR): 3.00 min]. The kappa value between Endoscopic Ruler and the endoscopists while detecting large OV was 0.52, demonstrating a moderate agreement. The kappa value for diagnosing large OV using Endoscopic Ruler among the six independent observers was 0.77, demonstrating a substantial agreement.</p><p><strong>Conclusion: </strong>The data demonstrates that Endoscopic Ruler is feasible and safe for measuring the size of varices in patients with cirrhosis and portal hypertension. Endoscopic Ruler is potential to promote the clinical practice of the two-grade classification system of OV.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 9","pages":"564-573"},"PeriodicalIF":2.0,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/b1/WJGE-15-564.PMC10514704.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human immunodeficiency virus patients with low CD4 counts are more likely to have precancerous polyps identified during index colonoscopy.","authors":"Michelle Likhtshteyn,&nbsp;Evan Marzouk,&nbsp;Fray M Arroyo-Mercado,&nbsp;Gurasees Chawla,&nbsp;Sabrina Rosengarten,&nbsp;Renata Lerer,&nbsp;Hector Ojeda-Martinez,&nbsp;Savanna Thor","doi":"10.4253/wjge.v15.i9.545","DOIUrl":"https://doi.org/10.4253/wjge.v15.i9.545","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Antiretroviral treatment (ART) has improved the life expectancy of patients living with human immunodeficiency virus (HIV). As these patients age, they are at increased risk for developing non-acquired immunodeficiency syndrome defining malignancies (NADMs) such as colon cancers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To determine which factors are associated with the development of precancerous polyps on screening colonoscopy in patients with HIV and to investigate whether HIV disease status, measured by viral load and CD4 count, might influence precancerous polyp development.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective review of records at two urban academic medical centers was performed for HIV patients who had a screening colonoscopy between 2005-2015. Patients with a history of colorectal cancer or polyps, poor bowel preparation, or inflammatory bowel disease were excluded. Demographic data such as sex, age, race, and body mass index (BMI) as well as information regarding the HIV disease status such as CD4 count, viral load, and medication regimen were collected. Well-controlled patients were defined as those that had viral load &lt; 50 copies, and poorly-controlled patients were those with viral load ≥ 50. Patients were also stratified based on their CD4 count, comparing those with a low CD4 count to those with a high CD4 count. Using colonoscopy reports in the medical record, the size, histology, and number of polyps were recorded for each patient. Precancerous polyps included adenomas and proximal serrated polyps. Data was analyzed using Fisher's exact tests and logistic regression through SAS 3.8 software.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Two hundred and seven patients met our inclusion criteria. The mean age was 56.13 years, and 58% were males. There were no significant differences in terms of age, race or ethnicity, insurance, and smoking status between patients with CD4 counts above or below 500. BMI was lower in patients with CD4 count &lt; 500 as compared to those with count &gt; 500 (&lt;i&gt;P&lt;/i&gt; = 0.0276). In patients with CD4 &gt; 500, 53.85% of patients were female, and 70.87% of patients with CD4 &lt; 500 were male (&lt;i&gt;P&lt;/i&gt; = 0.0004). Only 1.92% of patients with CD4 ≥ 500 had precancerous polyps &lt;i&gt;vs&lt;/i&gt; 10.68% of patients with CD4 &lt; 500 (&lt;i&gt;P&lt;/i&gt; = 0.0102). When controlled for sex, BMI, and ART use, patients with CD4 &lt; 500 were 9.01 times more likely to have precancerous polyps [95% confidence interval (CI): 1.69-47.97; &lt;i&gt;P&lt;/i&gt; = 0.0100]. Patients taking non-nucleoside reverse transcriptase inhibitors were also found to be 10.23 times more likely to have precancerous polyps (95%CI: 1.08-97.15; &lt;i&gt;P&lt;/i&gt; = 0.0428). There was not a significant difference noted in precancerous polyps between those that had viral loads greater or less than 50 copies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Patients with low CD4 counts were more likely to have precancerous polyps on their screening colonoscopy although the etiology for this assoc","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 9","pages":"545-552"},"PeriodicalIF":2.0,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/e8/WJGE-15-545.PMC10514706.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41104138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of trans-gastric <i>vs</i> trans-enteric (trans-duodenal or trans-jejunal) endoscopic ultrasound guided gallbladder drainage using lumen apposing metal stents.","authors":"Dheera Grover,&nbsp;Ifrah Fatima,&nbsp;Murali Dharan","doi":"10.4253/wjge.v15.i9.574","DOIUrl":"https://doi.org/10.4253/wjge.v15.i9.574","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasound guided gallbladder drainage (EUS-GBD) is being increasingly used in practice (either as a bridge to cholecystectomy in high-risk patients or as destination therapy in non-surgical patients). Stents are used to create a conduit between the lumen of the gallbladder (GB) and the intestinal lumen through the gastric or enteric routes. Among the various types of stents used, cautery-enhanced lumen apposing metallic stents (LAMS) may be associated with fewer adverse events (AEs).</p><p><strong>Aim: </strong>To compare the clinical success, technical success, and rate of AEs between transgastric (TG) and trans-enteric [transduodenal (TD)/transjejunal (TJ)] approach to GB drainage. Further, we analyzed whether using cautery enhanced stents during EUS-GBD impacts the above parameters.</p><p><strong>Methods: </strong>Study was registered in PROSPERO (CRD42022319019) and comprehensive literature review was conducted. Manuscripts were reviewed for the data collection: Rate of AEs, clinical success, and technical success. Random effects model was utilized for the analysis.</p><p><strong>Results: </strong>No statistically significant difference in clinical and technical success between the TD/TJ and TG approaches (<i>P</i> > 0.05) were noted. There was no statistically significant difference in the rate of AEs when comparing two-arm studies only. However, when all studies were included in the analysis difference was almost significant favoring the TD/TJ approach. When comparing cautery-enhanced LAMS with non-cautery enhanced LAMS, a statistically significant difference in the rate of AEs was observed when all the studies were included, with the rate being higher in non-cautery enhanced stents (14.0% <i>vs</i> 37.8%; <i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>As per our study results, TD/TJ approach appears to be associated with lower rate of adverse events and comparable efficacy when compared to the TG approach for the EUS-GBD. Additionally, use of cautery-enhanced LAMS for EUS-GBD is associated with a more favorable adverse event profile compared to cold LAMS. Though the approach chosen depends on several patient and physician factors, the above findings could help in deciding the ideal drainage route when both TG and TD/TJ approaches are feasible.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 9","pages":"574-583"},"PeriodicalIF":2.0,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/73/WJGE-15-574.PMC10514705.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute pancreatitis following endoscopic ampullary biopsy: A case report.","authors":"Nidhi Mariam George,&nbsp;Nanda Amarnath Rajesh,&nbsp;Tharun Ganapathy Chitrambalam","doi":"10.4253/wjge.v15.i8.540","DOIUrl":"https://doi.org/10.4253/wjge.v15.i8.540","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic biopsy is mandatory for the diagnosis of malignant and premalignant ampullary tumours. The commonly reported inadvertent complications following routine mucosal biopsy include perforation and haemorrhage. Acute pancreatitis is an extremely rare complication following this procedure.</p><p><strong>Case summary: </strong>This report details the case of a 59-year-old man who underwent biopsy of the ampulla for a suspected periampullary tumour. Following the procedure, the patient presented with symptoms of acute pancreatitis which was substantiated by laboratory and radiological investigations. He was conservatively managed and discharged following complete resolution of symptoms.</p><p><strong>Conclusion: </strong>This case report serves to highlight the importance of this potential complication following routine endoscopic biopsy of the ampulla.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 8","pages":"540-544"},"PeriodicalIF":2.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/82/c7/WJGE-15-540.PMC10473905.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10505543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic ultrasound artificial intelligence-assisted for prediction of gastrointestinal stromal tumors diagnosis: A systematic review and meta-analysis.","authors":"Rômulo Sérgio Araújo Gomes,&nbsp;Guilherme Henrique Peixoto de Oliveira,&nbsp;Diogo Turiani Hourneaux de Moura,&nbsp;Ana Paula Samy Tanaka Kotinda,&nbsp;Carolina Ogawa Matsubayashi,&nbsp;Bruno Salomão Hirsch,&nbsp;Matheus de Oliveira Veras,&nbsp;João Guilherme Ribeiro Jordão Sasso,&nbsp;Roberto Paolo Trasolini,&nbsp;Wanderley Marques Bernardo,&nbsp;Eduardo Guimarães Hourneaux de Moura","doi":"10.4253/wjge.v15.i8.528","DOIUrl":"https://doi.org/10.4253/wjge.v15.i8.528","url":null,"abstract":"<p><strong>Background: </strong>Subepithelial lesions (SELs) are gastrointestinal tumors with heterogeneous malignant potential. Endoscopic ultrasonography (EUS) is the leading method for evaluation, but without histopathological analysis, precise differentiation of SEL risk is limited. Artificial intelligence (AI) is a promising aid for the diagnosis of gastrointestinal lesions in the absence of histopathology.</p><p><strong>Aim: </strong>To determine the diagnostic accuracy of AI-assisted EUS in diagnosing SELs, especially lesions originating from the muscularis propria layer.</p><p><strong>Methods: </strong>Electronic databases including PubMed, EMBASE, and Cochrane Library were searched. Patients of any sex and > 18 years, with SELs assessed by EUS AI-assisted, with previous histopathological diagnosis, and presented sufficient data values which were extracted to construct a 2 × 2 table. The reference standard was histopathology. The primary outcome was the accuracy of AI for gastrointestinal stromal tumor (GIST). Secondary outcomes were AI-assisted EUS diagnosis for GIST <i>vs</i> gastrointestinal leiomyoma (GIL), the diagnostic performance of experienced endoscopists for GIST, and GIST <i>vs</i> GIL. Pooled sensitivity, specificity, positive, and negative predictive values were calculated. The corresponding summary receiver operating characteristic curve and post-test probability were also analyzed.</p><p><strong>Results: </strong>Eight retrospective studies with a total of 2355 patients and 44154 images were included in this meta-analysis. The AI-assisted EUS for GIST diagnosis showed a sensitivity of 92% [95% confidence interval (CI): 0.89-0.95; <i>P</i> < 0.01), specificity of 80% (95%CI: 0.75-0.85; <i>P</i> < 0.01), and area under the curve (AUC) of 0.949. For diagnosis of GIST <i>vs</i> GIL by AI-assisted EUS, specificity was 90% (95%CI: 0.88-0.95; <i>P</i> = 0.02) and AUC of 0.966. The experienced endoscopists' values were sensitivity of 72% (95%CI: 0.67-0.76; <i>P</i> < 0.01), specificity of 70% (95%CI: 0.64-0.76; <i>P</i> < 0.01), and AUC of 0.777 for GIST. Evaluating GIST <i>vs</i> GIL, the experts achieved a sensitivity of 73% (95%CI: 0.65-0.80; <i>P</i> < 0.01) and an AUC of 0.819.</p><p><strong>Conclusion: </strong>AI-assisted EUS has high diagnostic accuracy for fourth-layer SELs, especially for GIST, demonstrating superiority compared to experienced endoscopists' and improving their diagnostic performance in the absence of invasive procedures.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 8","pages":"528-539"},"PeriodicalIF":2.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/cd/WJGE-15-528.PMC10473903.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10208218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental trauma in endoscopy: A systematic review and experience of a tertiary endoscopy centre.","authors":"Chelsea Qiu Lin Tan,&nbsp;Gabrielle Yi Wen Loh,&nbsp;Tay Wei Rong Benjamin,&nbsp;Calvin Jianyi Koh,&nbsp;John Shao Rong Mok,&nbsp;Juanda Leo Hartono,&nbsp;Kai Ting Cheryl Chua,&nbsp;Hee Hon Tan,&nbsp;Kewin Tien Ho Siah","doi":"10.4253/wjge.v15.i8.518","DOIUrl":"https://doi.org/10.4253/wjge.v15.i8.518","url":null,"abstract":"<p><strong>Background: </strong>Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of endoscopy.</p><p><strong>Aim: </strong>To determine frequency and effects of dental injury in endoscopy, we present findings from an audit of outpatient endoscopy procedures conducted at a tertiary university hospital and a systematic review of literature.</p><p><strong>Methods: </strong>Retrospective review of 11265 outpatient upper endoscopy procedures over the period of 1 June 2019 to 31 May 2021 identified dental related complications in 0.284% of procedures. Review of literature identified a similar rate of 0.33%.</p><p><strong>Results: </strong>Pre-existing dental pathology or the presence of prostheses makes damage more likely but sound teeth may be affected. Pre-endoscopic history and tooth examination are key for risk stratification and may be conducted succinctly with limited time outlay. Tooth retrieval should be prioritized in the event of dental injury to minimize aspiration and be followed by prompt dental consultation for specific management.</p><p><strong>Conclusion: </strong>Dental complications occur in approximately 1 in 300 of upper endoscopy cases. These are easily preventable by pre-endoscopy screening. Protocols to mitigate dental injury are also suggested.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 8","pages":"518-527"},"PeriodicalIF":2.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/4b/WJGE-15-518.PMC10473904.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10505542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}