Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii最新文献

{"title":"A Case of Medullary Carcinoma of the Jejunum Combined with the Intestinal Lymphangiectasia Accompanied by the Malabsorption Syndrome","authors":"O. A. Lobanova, D. S. Trusova, M. A. Afonina, V. E. Varentsoy, D. D. Protsenko, N. V. Kretova, N. B. Serezhnikova, M. A. Peshkova, N. V. Zharkov, S. E. Kochetkova, Yu. Yu. Stepanova, Z. D. Shtanev, K. A. Vekhova, V. A. Yumasheva, A. O. Kolesnikova, M. Akan, M. O. Chanturiya, T. V. Serebrov, A. S. Tertychnyy, H. Guski, E. E. Rudenko, T. A. Demura, E. A. Kogan","doi":"10.22416/1382-4376-2023-33-4-92-100","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-4-92-100","url":null,"abstract":"Aim: to present a clinical and morphological observation of an extremely rare combination of medullary carcinoma of the jejunum and intestinal lymphangiectasia in a 33-year-old patient with clinical features of malabsorption syndrome over the 10 years. Key points. An autopsy revealed a tumor formation spreading from the wall of the jejunum to the mesentery, with metastases to the mesenteric lymph nodes. The medullary carcinoma with positive expression of СD117, DOG1, EMA, PanCK, PDL-1, vimentin, mosaic non-intense expression of CA19-9, calretinin, CD10, CDX2, CEA, MUC-5AC, SATB2, and negative reaction to ALK, CD3, CD8, CD20, CD30, CD31, CD34, CD45, CD56, chromogranin, CK7, CK20, desmin. The proliferative index was high: Ki-67 > 80 %. Moreover, during the histological examination of the intestinal wall, intestinal lymphangiectasia complicated by the malabsorption syndrome was revealed. Conclusion. The uniqueness of this clinical and morphological case is in the combination of medullary carcinoma of the jejunum metastasized to the mesenteric lymph nodes with the underlying intestinal lymphangiectasia accompanied by the development of malabsorption syndrome.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"145 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135978296","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":"Modern Possibilities of Using Lactulose in Clinical Practice","authors":"A. A. Sheptulin","doi":"10.22416/1382-4376-2023-33-4-70-75","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-4-70-75","url":null,"abstract":"Aim of the publication. To present an overview of current literature data on the possibilities of application of lactulose in clinical practice. Key findings . Lactulose is a synthetic disaccharide belonging to the class of osmotic laxatives. Officially permitted indications for its appointment in Russian Federation are functional constipation (including in children, the elderly and senile, pregnant women and women in postpartum period), an obstipation type of irritable bowel syndrome, the need to soften the consistency of feces in hemorrhoids and anal fissures, after operations on the colon and anorectal area, as well as hepatic encephalopathy. Other indications include preparation for colonoscopy, treatment and prevention of disorders of the intestinal microbiota, prevention of constipation in oncological patients receiving narcotic analgesics, as well as patients on artificial lung ventilation. Conclusion . Lactulose is a highly effective and safe drug, which combines osmotic laxative effect with expressed prebiotic action and is used in a wide clinical practice.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"42 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135978295","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":"Practical Aspects of Clinical Manifestations, Pathogenesis and Therapy of Alcoholic Liver Disease and Non-alcoholic Fatty Liver Disease: Expert Opinion","authors":"V. V. Tsukanov, M. F. Osipenko, E. V. Beloborodova, M. A. Livzan, I. B. Khlynov, S. A. Alekseenko, Yu. P. Sivolap, J. L. Tonkikh, A. V. Vasyutin","doi":"10.22416/1382-4376-2023-33-4-7-13","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-4-7-13","url":null,"abstract":"Aim: to present the results of an expert discussion of modern aspects of the clinical manifestations, pathogenesis and treatment of alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). Key points. ALD and NAFLD are characterized by high prevalence and have a significant impact on public health. For the diagnosis of liver pathology, it is important to determine the stage of fibrosis and the severity of the exacerbation of the disease. In the treatment of ALD, it is recommended to achieve abstinence, proper nutrition, the appointment of B vitamins, drugs with cytoprotective activity. In severe hepatitis, corticosteroids may be prescribed. In the treatment of NAFLD, diet and lifestyle modification, weight loss, the use of insulin sensitizers, vitamin E, statins (in the presence of hyperlipidemia) and drugs with metabolic activity are effective. Currently, a point of view is being actively expressed about the synergism of the action of alcohol and the metabolic syndrome on the development of fibrosis, cirrhosis, and hepatocellular carcinoma. The current international consensus recommends a change in the nomenclature of NAFLD and ALD and proposes the terms “metabolically associated steatotic liver disease” and “metabolically associated alcoholic liver disease”. Conclusion. The closeness of the clinical manifestations and pathogenesis of NAFLD and ALD justifies attention to drugs with metabolic activity, which are recommended by the Russian Gastroenterological Association and Russian Scientific Liver Society for the treatment of these diseases. The experts support the suggestion to quantify alcohol consumption in patients with NAFLD in order to change the management of patients, if necessary.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"169 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134972560","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":"Esophageal Lichen Planus as a Cause of Dysphagia: Literature Review and Clinical Observation","authors":"A. I. Dolgushina, E. R. Olevskaya, A. O. Khikhlova, A. A. Saenko, S. U. Belousov","doi":"10.22416/1382-4376-2023-33-4-76-84","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-4-76-84","url":null,"abstract":"Aim: to analyze the literature data, and to raise awareness of doctors of various specialties about the methods of diagnosis and treatment of esophageal lichen planus (ELP). Key points. In a 67-year-old female patient with complaints of difficulty swallowing solid food and weight loss, esophagogastroduodenoscopy revealed subcompensated stenosis of the middle third of the esophagus and signs of fibrinous esophagitis. Based on the characteristics of the endoscopic picture and the detection of apoptotic Ciwatt bodies in esophageal biopsies, a diagnosis of ELP was established. Treatment with glucocorticosteroids led to relief of symptoms and positive endoscopic dynamics. ELP is rare and the least studied, data on this disease in the literature are presented mainly in the form of clinical observations and analysis of series of cases. Typical clinical manifestations include dysphagia and odynophagia. Despite the low prevalence, ELP can be associated with serious complications: stenosis and esophageal squamous cell carcinoma. Endoscopic examination reveals characteristic signs in the esophagus: swelling, thickening and increased vulnerability of the mucosa, often with fibrin, formation of membranes and strictures. The histological picture is represented by epithelial dyskeratosis with exfoliation, lichenoid lymphocytic infiltration. The most specific histological sign is the presence of apoptotic Civatte bodies. Recommendations for the treatment of ELP are limited to the results of a series of clinical observations and include the prescription of systemic corticosteroids. The issue of supportive therapy is the least studied. Conclusion. Analysis of the literature data and the clinical case demonstrate that lichen planus of the esophagus is one of the rare causes of dysphagia. Characteristic endoscopic and histological signs are key for the diagnosis. The management of patients with esophageal lichen planus is insufficiently defined and today includes taking of glucocorticosteroids, endoscopic dilation of stricture and dynamic endoscopic observation, given the high risk of squamous cell carcinoma in this category of patients.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"12 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134972559","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":"Immediate Results of Colonic Flat Epithelial Neoplasms Removal Using Diathermic Snare Endoscopic Mucosal Resection and Mucosectomy Combined with Dissection in the Submucosal Layer: Comparative Assessment","authors":"A. A. Fedorenko, P. V. Pavlov, A. P. Kiryukhin, A. S. Tertychnyy","doi":"10.22416/1382-4376-2023-33-4-14-23","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-4-14-23","url":null,"abstract":"Aim: to compare the immediate outcomes of removing colonic flat epithelial neoplasms by using diathermic snare endoscopic mucosal resection (EMR) and mucosectomy with endoscopic submucosal dissection (ESD). Materials and methods. Ninety-six endoscopic procedures were conducted on the colon of 93 patients with flat epithelial neoplasms. The mean age of patients was 64.9 ± 10.7 years, with an age range of 39 to 88 years. The size range of epithelial neoplasms was 20 to 70 mm, with a median of 37.4 ± 14.8 mm. Only patients with benign epithelial neoplasms were included in the study since patients with suspected malignancy in laterally spreading tumors are indicated for ESD intervention to avoid fragmentary excision and risk of colorectal cancer progression due to possible positive resection margins. The patients were separated into two equally sized groups and treated with EMR and ESD methods. Results. Epithelial neoplasms in the ESD group had an average size of 41.6 ± 15 mm while those in the EMR group had an average size of 33.1 ± 13.5 mm. The ESD group had an average intervention time of 143.6 ± 102.9 min, whereas the EMR group had an average intervention time of 52.6 ± 34.4 min. Both groups (96 adenomas) had a total of 10 (10.4 %) patients who experienced colonic perforations during the intervention, with 4 (4.1 %) cases observed in the EMR group and 6 (6.2 %) in the ESD group. No statistically significant differences were identified in the occurrence of perforations during the operation ( p = 0.7401). ESD resulted in an en bloc removal rate of 44/48 (91.6 %), whereas EMR only achieved a rate of 14/48 (29.1 %). Conclusion. Endoscopic mucosectomy with submucosal dissection (ESD), in contrast to endoscopic mucosal resection (EMR) with diathermic snare, provides a higher frequency of tumor removal en bloc, regardless of tumor size, but is characterized by a longer duration of intervention ( p < 0.0001). In the ESD group, there were twice as many intraoperative bleedings ( p = 0.0061) due to the longer duration and technical complexity of the procedure. There were no statistically significant differences in the incidence of late complications between the groups ( p = 0.9999). Local recurrence of adenoma developed in two patients (4.1 %) after pEMR, statistically significant differences were noted ( p < 0.0006).","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135252331","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":"Two-Stage Treatment of Enterocutaneous Fistulas","authors":"V. Yu. Struchkov, S. V. Berelavichus, E. A. Akhtanin, D. S. Gorin, M. V. Dvukhzhilov, A. A. Goev, A. I. Burmistrov, P. V. Markov, A. G. Kriger","doi":"10.22416/1382-4376-2023-33-4-58-69","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-4-58-69","url":null,"abstract":"Aim: to determine the most efficient treatment of enterocutaneous fistulas. Materials and methods. Eighty-eight patients with intestinal fistulas underwent a two-stage treatment, including: the first stage — multicomponent therapy, the second stage — reconstructive surgery. Enterocutaneous fistulas were diagnosed in 61 patients, enteroatmospheric fistulas — in 26 patients, and combined fistula (enterocutaneous and enteroatmospheric) — in 1 patient. Results. All 88 patients underwent reconstructive surgery after the multicomponent therapy. Resection of the intestine with a fistula with the formation of an entero-entero anastomosis was performed in 72 (81.8 %) patients; marginal resection of the intestine with a fistula, followed by suturing of the defect — in 7 (8.0 %); resection of the intestine with fistulas in combination with excision and suturing of the fistula — in 5 (5.7 %); an operation aimed at disabling the fistula from the passage of intestinal contents — in 3 (3.4 %); resection of the intestine with a fistula in combination with fistula exclusion — in 1 (1.1 %) patient. Postoperative complications in the group of patients with enteroatmospheric fistulas occurred in 13 cases, in the group with enterocutaneous fistulas — in 25 patients. Three (3.4 %) patients with enterocutaneous fistulas died from complications unrelated to the underlying disease and surgical interventions. Conclusion. Two-stage treatment including multicomponent therapy (nutritional support, infection generalization control, local wound treatment) and reconstructive surgery allowed to reduce mortality rates to 3.4 %, which proves the effectiveness of this method.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135343636","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":"Research of &lt;i&gt;PNPLA3&lt;/i&gt; I148M Gene Polymorphism in Patients with Non-Alcoholic Fatty Liver Disease, with Liver Cirrhosis and with Hepatocellular Carcinoma","authors":"V. V. Petkau, G. A. Tsaur, E. N. Bessonova, A. A. Karimova","doi":"10.22416/1382-4376-2023-33-4-30-37","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-4-30-37","url":null,"abstract":"Aim: to determine the frequency of PNPLA3 rs738409 C>G gene polymorphism, leading to p .I148M substitution, in patients with non-alcoholic fatty liver disease (NAFLD), and to reveal the association between polymorphism and probable NAFLD outcomes: liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Materials and methods. The study was conducted according to the “case-control” design, three main groups were formed: a group with NAFLD ( n = 46), a group with LC ( n = 61), a group with HCC ( n = 50), as well as a control group ( n = 70), for all groups we performed genotyping of the rs738409 polymorphism of the PNPLA3 gene. The relationship between the occurrence of different genotype variants and the diagnosis of patients was evaluated, the odds ratio (OR) of progression of NAFLD and the reliability of intergroup differences were determined. Results. NAFLD patients with PNPLA3 I148M polymorphism have a significantly higher chance of developing LC and HCC. The odds ratio for the GG genotype was 7.94 (95 % Cl: 2.19–28.84; p = 0.030) for LC and 6.51 (95 % Cl: 1.15–4.08; p = 0.039) — for HCC with concomitant LC. The presence of the minor G allele also increases the likelhood of transition from NAFLD to LC (OR = 2.38; 95 % Cl: 1.41–4.02; p = 0.010) and HCC in the presence of cirrhosis (OR = 2.17; 95 % Cl: 1.15–4.08; p = 0.039). Differences in the frequency of PNPLA3 polymorphism between the NAFLD and HCC groups were not significant. Additional risk factors for HCC associated with NAFLD are overweight (OR = 5.14; 95 % Cl: 1.94–13.67; p < 0.001), arterial hypertension (OR = 8.49; 95 % Cl: 3.05–23,62; p < 0.001) and diabetes mellitus (OR = 8.57; 95 % Cl: 1.03–71.48; p = 0.032). Conclusion. The frequency of single nucleotide polymorphism PNPLA3 significantly differs in patients with NAFLD, cirrhosis and HCC compared with the control group of healthy volunteers. The PNPLA3 I148M polymorphism increases the incidence of NAFLD progression to cirrhosis and HCC, but only with concomitant cirrhosis.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135109470","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":"Cytokines in Liver Cirrhosis (Their Importance in Assessing Activity and Decompensation)","authors":"G. K. Mirodzhov, S. D. Pulatova","doi":"10.22416/1382-4376-2023-33-4-24-29","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-4-24-29","url":null,"abstract":"Aim: studying the role of pro-inflammatory and anti-inflammatory cytokines in the pathogenesis of liver cirrhosis progression. Materials and methods. The material of the study was the data of clinical-instrumental, biochemical, virological studies of 109 patients with liver cirrhosis of various etiologty, who were hospitalized in the clinic of the Institute of Gastroenterology (Dushanbe, Republic of Tajikistan). The diagnosis of the underlying disease was established according to the clinical recommendations of the Russian Society for the Study of the Liver and the Russian Gastroenterological Association for the diagnosis and treatment of liver fibrosis and cirrhosis and their complications (2021); decompensated liver cirrhosis was established according to the 1996 Child — Pugh classification. The age of the patients ranged from 17 to 79 years (36.9 ± 0.8 years), there were 55 men and 54 women. Results. Among the examined patients, compensated liver cirrhosis (Class A) according to Child — Pugh was detected in 18 persons, subcompensated (Class B) — in 14, decompensated (Class C) — in 77. The study of the content of pro-inflammatory and anti-inflammatory cytokines in the blood serum of patients with Class A liver cirrhosis showed, that levels of tumour necrosis factor alpha (TNF-α), interleukin-2, interleukin-6 were statistically higher compared to healthy individuals, while the concentration of anti-inflammatory interleukin-10 was lower (30.7 ± 4.7 pg/mL) in comparison with the control group. In patients with Class B liver cirrhosis, the level of TNF-α increased to 75.0 ± 4.5 pg/mL ( p < 0.001), interleukin-2 — to 328.7 ± 23.9 pg/mL ( p < 0.05), and interleukin-6 — to 95.4 ± 7.7 pg/mL ( p < 0.001). Serum interleukin-10 decreased compared with the control group (23.1 ± 2.8 pg/mL; p > 0.05). At the decompensated stage of Class C cirrhosis, a huge release of pro-inflammatory cytokines occurs — the content of TNF-α increases by 80 times, of interleukin-2 — by more than 60 times, аs for interleukin-10, its content is progressively reduced. Conclusion. In liver cirrhosis, there is a significant disruption in the synthesis of pro-inflammatory cytokines, which is manifested by a sharp increase in the content of TNF-α, interleukin-2 and interleukin-6. High levels of proinflammatory cytokines in blood serum in liver cirrhosis correlate with the activity and degree of decompensation, which indicates their important role in the pathogenesis and progression of the pathological process.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786787","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":"Echinococcal Cyst Blockade — the Rare Cause of Acute Pancreatitis and Obstructive Jaundice","authors":"S. A. Budzinskiy, S. G. Shapovaliants, R. V. Plakhov, M. V. Murashkina, E. A. Vorobyeva, D. R. Berdieva, P. V. Usyaky, E. D. Fedorov","doi":"10.22416/1382-4376-2023-33-4-85-91","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-4-85-91","url":null,"abstract":"Aim: demonstrate an algorithm for the diagnosis and treatment of acute pancreatitis and obstructive jaundice caused by obstruction of the terminal part of the common bile duct by daughter echinococcal cyst. Key points. The article presents a clinical case of acute echinococcal obstruction of the terminal part of the common bile duct in a patient with a complicated course of liver echinococcosis. A 33-year-old man was hospitalized with epigastrium and right hypochondrium pains and jaundice. In 2019 the patient underwent the removal of a cyst in the 7th liver segment and cholecystectomy for liver and gallbladder echinococcal lesions. Laboratory research revealed leukocytosis, hyperbilirubinemia and an increase in the transaminases level. Transabdominal ultrasound showed signs of dilatation throughout bile ducts. Duodenoscopy revealed a fixed yellowish-white oval formation with transluent capsule, completely blocking bile and pancreatic juice outflow at the major duodenal papilla. After non-annulation endoscopic papillotomy, migration of the substrate (echinococcal cyst) into the duodenum was noted, active flow of bile and pancreatic secretions was restored. Oral transpapillary cholangioscopy was performed for a detailed bile ducts examination. It revealed no echinococcal cysts, residual parasitic structures or biliary tree lesions. The treatment was completed with pancreatic stenting. After complex treatment in the intensive care and surgery unit with complete condition stabilization, the patient was discharged with recommendations for further treatment in a specialized clinic. Conclusion. Migration of a daughter cyst from the echinococcal liver focus can cause acute blockade of the terminal part of the common bile duct and acute obstructive pancreatitis. The combination of clinical, radiological and endoscopic methods allows to diagnose and eliminate this rare complication of liver echinococcosis with subsequent successful treatment.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786788","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":"Clinical and Morphological Features of Dysplasia and Early Gastric Cancer in the Patients with Autoimmune Gastritis","authors":"A. S. Tertychnyy, N. V. Pachuashvili, D. P. Nagornaya, T. L. Lapina, E. A. Losik, A. B. Ponomarev, P. V. Pavlov, A. P. Kiryukhin, A. A. Fedorenko, D. D. Protsenko, V. T. Ivashkin","doi":"10.22416/1382-4376-2023-33-3-16-33","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-3-16-33","url":null,"abstract":"А im: to analyze a series of cases of dysplasia and early gastric cancer developed in patients with autoimmune gastritis (AIG), and to identify their clinical and morphological features. Materials and methods. The study included six cases of detection of early gastric cancer on the background of AIG. Four out of six patients underwent endoscopic treatment, and in three out of six cases patients underwent endoscopic mucosectomy with dissection in the submucosal layer. One patient underwent endoscopic surgery in 2017, he continues annual dynamic follow-up without signs of tumour recurrence. A female patient with type 1 neuroendocrine tumour and mild dysplasia is awaiting treatment. Results. In five out of six patients with AIG, the localization of lesions prevailed in the stomach body, while all detected tumours were early ones, and according to the immunophenotype — of a gastric type. The presented cases of tumours were not accompanied by hyperplasia of neuroendocrine cells directly in the area of the tumour itself, but only in the surrounding gastric mucosa. Additionally, several cases of early gastrointestinal stromal tumours were found, which were characterized by low proliferative activity and had small sizes. Conclusion. The predominance of pseudopyloric metaplasia in the surrounding mucosa allows us to consider pseudopyloric metaplasia as a potentially significant change in the gastric mucosa of patients with AIG that may precede the development of gastric cancer.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136025587","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}