JGH Open最新文献

{"title":"Rapid Resolution of Anabolic Androgenic Steroid-Induced Refractory Pruritus and Bile Cast Nephropathy With Therapeutic Plasma Exchange","authors":"Samuel Wong,&nbsp;Danny Con,&nbsp;Avik Majumdar","doi":"10.1002/jgh3.70130","DOIUrl":"https://doi.org/10.1002/jgh3.70130","url":null,"abstract":"<p>The proportion of non-paracetamol drug-induced liver injury (DILI) is increasing in Australia and other Western countries. Androgenic anabolic steroids (AAS) commonly cause a bland cholestasis that can persist for months despite withdrawal. A 35-year-old male presented with progressive painless jaundice associated with pruritus, nausea, loss of weight, dark urine, and pale stools. He had recently commenced AAS; DILI was suspected and confirmed on biopsy. His pruritus was refractory to medical therapy, and PLEX was commenced. He also developed renal failure from bile cast nephropathy (BCN) and required hemodialysis. At 10 weeks post-discharge, his pruritus and jaundice were significantly improved, and his renal function had completely recovered. The case adds to the growing evidence that PLEX can be used safely and effectively to treat cholestatic pruritus and BCN.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632699","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":"Asymptomatic Gastric Metastasis From Ovarian Adenocarcinoma Presented as Gastric Subepithelial Tumor: Case Report","authors":"Qiyu Yang,&nbsp;Aihua Li,&nbsp;Zeyu Lu,&nbsp;Shihang Tang","doi":"10.1002/jgh3.70135","DOIUrl":"https://doi.org/10.1002/jgh3.70135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ovarian tumor metastasis to the stomach is uncommon. Clinical manifestations of metastasis to the stomach are variable and lack features. Gastric metastasis resembling a subepithelial tumor is unusual, making the diagnosis challenging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>Here, we reported a case of gastric metastasis from ovarian adenocarcinoma presenting as a subepithelial tumor diagnosed by endoscopic ultrasound-guided tissue acquisition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case provides significant reference value and serves as a cautionary reminder for the diagnosis and management of gastric subepithelial tumors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632698","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":"Prospective Study to Assess Long-Term Outcomes of Chelator-Based Treatment With Trientine Dihydrochloride in Patients With Wilson Disease","authors":"Isabelle Mohr,&nbsp;Carlot Kruse,&nbsp;Verena Aliane,&nbsp;Karl Heinz Weiss","doi":"10.1002/jgh3.70114","DOIUrl":"https://doi.org/10.1002/jgh3.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Wilson disease is an inherited disorder of copper metabolism affecting mainly the liver and brain. Trientine dihydrochloride (TETA-2HCl) is approved for the treatment of Wilson disease in patients (≥ 5 years) intolerant to D-penicillamine therapy. This study assessed the long-term outcomes of treatment with TETA-2HCl in Wilson disease patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this Phase 2, prospective study, patients continued their treatment of TETA-2HCl 300 mg (200 mg trientine base) for 12 months (July 2015–April 2017) at one center in Germany. Primary outcomes were the safety and efficacy of TETA-2HCl treatment; Biomarkers of copper metabolism; and the course of hepatic and neurologic disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 51 patients contributed data. Almost all patients (50 [98.0%]) were considered responders (rating of ≤ 4 at the 12-month visit); Unified Wilson Disease Rating Scale scores improved throughout the study from a mean (standard deviation) of 11.3 (24.31) at Baseline to 8.8 (22.86) at Month 12. Biochemical assessments of liver parameters (transaminases, liver synthesis) as well as markers of copper metabolism (24-h urinary copper, non-ceruloplasmin bound copper (NCC)) showed improved or stable disease throughout the study. Treatment-emergent adverse events were reported in five (9.6%) patients. No patients withdrew from treatment due to adverse events, and no serious adverse events were considered to be treatment-related.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrated that treatment with TETA-2HCl was effective and well tolerated in hepatic and neurologic disease manifestations. Additionally, improvement in neurological symptoms was reported throughout the trial, suggesting that improvements may be reported for an extended period after initiation of therapy.</p>\u0000 \u0000 <p><b>Trial Registration:</b> NCT02426905</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639140","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":"Tegoprazan-Containing Versus Proton Pump Inhibitor-Containing Therapy for First-Line Eradication of Helicobacter pylori: A Meta-Analysis of Randomized Controlled Trials","authors":"Daniel Martin Simadibrata,&nbsp;Elvira Lesmana,&nbsp;Ivan Damara,&nbsp;Mochammad Izzatullah,&nbsp;Pojsakorn Danpanichkul,&nbsp;Hae Won Yoo,&nbsp;Su Jin Hong,&nbsp;Ari Fahrial Syam","doi":"10.1002/jgh3.70134","DOIUrl":"https://doi.org/10.1002/jgh3.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Concerns have been raised regarding the decreasing success rates of the standard treatment of <i>Helicobacter pylori</i> (proton pump inhibitor (PPI) and two/three antibiotics) and the long-term effects carried by PPI. Despite conflicting data, Tegoprazan, a potassium-competitive acid blocker, is hypothesized to be superior to PPI for eradicating <i>H pylori</i>. This systematic review and meta-analysis aim to determine the superiority of Tegoprazan-containing therapy to PPI-containing therapy for <i>H pylori</i> eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search identified studies published until December 12, 2024, from MEDLINE, EMBASE, SCOPUS, and CENTRAL. The search strategy included the following keywords: “Tegoprazan,” <i>“</i>Proton Pump Inhibitors,” <i>and “Helicobacter pylori</i>.<i>”</i> Only randomized controlled trials (RCTs) that compared the efficacy of Tegoprazan to any PPI were included. Risk of bias assessment was performed using the Cochrane Risk of Bias 2 (RoB2) tool for RCTs. The random-effect model was used to calculate the pooled risk ratio (RR) and its 95% Confidence Interval (95% CI) from the intention-to-treat population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six RCTs with low risks of bias were included in this meta-analysis. All studies included treatment-naïve patients and compared first-line <i>H pylori</i> treatment. The overall eradication rates of Tegoprazan-containing (<i>N</i> = 1052) versus PPI-containing therapy (<i>N</i> = 1058) were 83.37% and 80.06%, respectively (RR 1.045; 95% CI 1.008–1.084; <i>I</i>² = 0%). Tegoprazan-containing therapy demonstrated comparable treatment-emergent adverse event (TEAE) rates compared to PPI-containing therapy (46.48% vs. 46.31%; RR 1.026; 95% CI 0.952–1.106; <i>I</i>² = 48%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This meta-analysis demonstrated that Tegoprazan-containing therapy is superior to PPI-containing therapy for first-line <i>H pylori</i> eradication, with comparable safety profiles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602496","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":"Diagnostic Challenges in Atypical Familial Mediterranean Fever: Enhancing Diagnostic Accuracy Through Clinical and Genetic Criteria","authors":"Marouf Alhalabi,&nbsp;Hussam Aldeen Alshiekh","doi":"10.1002/jgh3.70133","DOIUrl":"https://doi.org/10.1002/jgh3.70133","url":null,"abstract":"&lt;p&gt;We read with great interest the recent case report, “Can Peritoneal Biopsy Diagnose Atypical Cases of Familial Mediterranean Fever?: A Case Report,” describing a 36-year-old Arab female with Familial Mediterranean Fever (FMF) and chronic low-gradient ascites [&lt;span&gt;1&lt;/span&gt;]. This case underscores the diagnostic difficulty associated with atypical FMF presentations; nonetheless, multiple methodological flaws, most notably the overreliance on nonspecific peritoneal biopsy results and the exclusion of MEFV mutation analysis, call into question the diagnosis's validity. Given the absence of definitive histopathological markers for FMF, the presence of neutrophilic infiltration alone is insufficient for diagnosis, as this finding is observed in various infectious such as tuberculosis, and bacterial peritonitis; Autoimmune such as lupus peritonitis; and autoinflammatory disorders such as TNF receptor-associated periodic syndrome [&lt;span&gt;1-3&lt;/span&gt;]. Furthermore, the lack of fibrin deposits occasionally seen in acute FMF and the absence of amyloidosis, a late-stage complication, further weaken the histological rationale [&lt;span&gt;4-6&lt;/span&gt;]. Diagnostic accuracy in FMF necessitates adherence to established clinical criteria, such as the Tel Hashomer guidelines, which prioritize major criteria (recurrent febrile serositis lasting 12–72 h, colchicine responsiveness, and amyloidosis in untreated cases) and minor criteria (family history, incomplete or atypical attacks, and heterozygous MEFV variants) [&lt;span&gt;7&lt;/span&gt;]. Unlike infectious or autoimmune mimics, FMF follows a characteristic episodic, self-limiting course, with colchicine responsiveness serving as a distinguishing feature. However, colchicine response alone lacks specificity, as it is shared with conditions such as Behçet's disease, gout, and idiopathic serositis, necessitating genetic confirmation or rigorous exclusion of alternative etiologies. In tuberculosis-endemic regions, misdiagnosis remains a significant concern, particularly given that peritoneal tuberculosis may lack granulomas in up to 50% of cases and can mimic FMF's neutrophilic inflammatory patterns [&lt;span&gt;7, 8&lt;/span&gt;]. The patient's presentation of chronic ascites without recurrent febrile episodes does not align with the major diagnostic criteria for FMF, and the omission of family history further weakens diagnostic plausibility in an autosomal recessive disease. Additionally, the absence of ascitic fluid analysis, including serum-ascites albumin gradient (SAAG), PCR for &lt;i&gt;Mycobacterium tuberculosis&lt;/i&gt;, and adenosine deaminase (ADA) testing, limits the exclusion of alternative diagnoses [&lt;span&gt;9&lt;/span&gt;]. To mitigate misclassification, we advocate for targeted MEFV sequencing (M694V/V726A variants in Arab populations), incorporation of SAAG-guided differential diagnostic protocols [&lt;span&gt;10&lt;/span&gt;], and strict adherence to established criteria with explicit symptom-criteria correlation. Moving forward, more research should focu","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595350","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":"Completion of Colonoscopy After Positive Fecal Occult Blood Test Screening at a Community Health Center","authors":"Niraj Gowda,&nbsp;Tatiana Rugeles Suarez,&nbsp;Chike Leigh,&nbsp;Lindsey Bierle,&nbsp;Michael Harring,&nbsp;Martin Maldonado-Puebla,&nbsp;Sean M. Lee,&nbsp;Neeral Shah,&nbsp;Jillian S. Catalanotti","doi":"10.1002/jgh3.70129","DOIUrl":"https://doi.org/10.1002/jgh3.70129","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Screening for colorectal cancer decreases mortality. Fecal occult blood testing (FOBT) decreases some barriers to screening, however positive results require colonoscopy. We evaluated factors associated with colonoscopy completion for community health center (CHC) patients after positive FOBT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We identified patients of one CHC with positive FOBT from 1/1/2018-12/31/2021. We performed chart reviews for demographics, insurance status, FOBT date, colonoscopy referral date and site, and colonoscopy results.</p>\u0000 \u0000 <p>We performed descriptive analysis. We fitted a logistic model and employed stepwise selection to evaluate effect of variables influencing likelihood of colonoscopy. We employed forward and backward model selection to identify the reduced model with the lowest Akaike Information Criterion score. Using this model, we calculated hypothesis tests for each coefficient using Wald tests with an alpha level of 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 50% of participants completed colonoscopy. Mean time between positive FOBT and colonoscopy completion was 237.4 days (SD 187.9). The reduced logistic model included age and health insurance covariates. Insured patients were 221.7% more likely to complete colonoscopy than uninsured patients. A seven-year increase in age was associated with 41.2% increase in likelihood of colonoscopy. An increase of 38 miles to the colonoscopy site was associated with 17.7% decrease in likelihood of completion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Only half of participants with positive FOBT completed colonoscopy. On average, nearly eight months elapsed between FOBT and colonoscopy. Having insurance was the strongest predictor of colonoscopy, despite available financial aid programs. Longer distances to colonoscopy sites decreased likelihood of completion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565230","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":"A Novel, Combined Endoscopic Technique to Reveal a Gastric Ulcer Underlying a Left Gastric Artery Pseudoaneurysm","authors":"Jinye Liu,&nbsp;Abdulazeez Swaiti,&nbsp;Francesco Giorgino,&nbsp;Saeed Graham,&nbsp;Zarak Hassan Khan,&nbsp;Edward Barcelona,&nbsp;Karissa Lambert","doi":"10.1002/jgh3.70132","DOIUrl":"https://doi.org/10.1002/jgh3.70132","url":null,"abstract":"<p>Pseudoaneurysms, or false aneurysms, result from an arterial wall tear and can arise from trauma, infection, or inflammation. Common types include aortic, cardiac, and femoral pseudoaneurysms, while left gastric artery pseudoaneurysms (LGAP) are rare visceral occurrences, with only a handful of documented cases. LGAPs are often associated with recurrent pancreatitis and require prompt recognition and treatment due to their high risk of rapid bleeding and fatal outcomes if left untreated. We present a case of a hemodynamically unstable patient with a significant clot burden, successfully managed with a novel approach that revealed an LGAP with a penetrating gastric ulcer at the pseudoaneurysm site.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571230","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":"Neutrophil-Lymphocyte Ratio May be Used as a Biomarker for Predicting Progression of Barrett's Esophagus to Esophageal Adenocarcinoma: A Retrospective Cohort Study","authors":"Zarian Prenatt,&nbsp;Het Patel,&nbsp;Naomi Reddy-Patel,&nbsp;Janak Bahirwani,&nbsp;Parampreet Kaur,&nbsp;Yecheskel Schneider","doi":"10.1002/jgh3.70115","DOIUrl":"https://doi.org/10.1002/jgh3.70115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aims to investigate the correlation between the neutrophil-lymphocyte ratio (NLR) and advancing stages of Barrett's esophagus (BE) to esophageal adenocarcinoma (EAC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A retrospective cohort of patients diagnosed with BE and EAC were analyzed. Cases were categorized into four groups according to their histological diagnosis: non-dysplastic BE (NDBE), low-grade dysplasia (LGD), high-grade dysplasia (HGD), and EAC. The NLR was calculated from a complete blood cell count within 6 months prior to diagnosis. A total of 140 patients were analyzed with a mean age of 67. The majority of patients were male (78.6%) and Caucasian (96.4%). Of the total, 32 (22.9%) patients had NDBE, 20 (14.3%) had LGD, 20 (14.3%) had HGD, and 68 (48.6%) had EAC. There was a statistically significant difference in NLR scores across the histological diagnoses. The mean NLR rank scores were 48.22 for NDBE, 44.75 for LGD, 60.35 for HGD, and 91.54 for EAC. Post hoc tests confirmed significant differences in NLR between NDBE and EAC, as well as LGD and EAC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study supports the potential use of NLR as a biomarker for predicting histologic progression in BE to EAC. The NLR could serve as a useful adjunct to current surveillance strategies to help guide clinical decision-making. Further research is necessary to validate these findings and determine the clinical utility of NLR as a predictor for dysplasia and neoplasia in BE patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565192","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 Treatment and Considerations for a Rare of Killian-Jamieson Diverticulum: A Case Report","authors":"Guoyao Sun,&nbsp;Wen Jia,&nbsp;Zhuo Yang,&nbsp;Jiao Liu,&nbsp;Yong Sun","doi":"10.1002/jgh3.70127","DOIUrl":"https://doi.org/10.1002/jgh3.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pharyngoesophageal diverticulum, including the most common Zenker's diverticulum, Killian-Jamieson diverticulum, and the rarer Laimer's diverticulum, require accurate differentiation for proper treatment. This case report explores the endoscopic features and the diagnostic and therapeutic value of endoscopic ultrasound (EUS) in the management of Killian-Jamieson diverticulum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 57-year-old woman presented with dysphagia for solids over the past three months. Esophagogastroduodenoscopy (EGD) revealed an esophageal diverticulum located below the upper esophageal sphincter. EUS measured the diverticulum to be 1.0 cm by 1.4 cm and confirmed the absence of muscularis propria, thereby ruling out Laimer's diverticulum. The patient underwent flexible endoscopic septum division (FESD) without any adverse events. A barium esophagram three months post-surgery indicated a left-sided Killian-Jamieson diverticulum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case highlights the importance of combining endoscopic features with barium swallow and EUS for accurate diagnosis of Killian-Jamieson diverticulum. The results suggest that such an integrated diagnostic approach enhances diagnostic accuracy and guides treatment, offering insights into the management of pharyngoesophageal diverticulum.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554750","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":"Methimazole-induced cholestasis initially obscured by an incidental finding of a large periampullary diverticulum: A case report with reference to the updated RUCAM of 2016","authors":"Salomon Chamay,&nbsp;Ari Alter,&nbsp;Rooshi Parikh,&nbsp;Shivam Khatri,&nbsp;Deepa Budh,&nbsp;Mitchell Spinnell","doi":"10.1002/jgh3.13042","DOIUrl":"https://doi.org/10.1002/jgh3.13042","url":null,"abstract":"<p>Methimazole is a commonly prescribed drug for hyperthyroidism and is generally well-tolerated, with complications occurring in less than 10% of treated patients. To our knowledge, there are approximately 30 reported cases of drug-induced liver injury (DILI) associated with the use of methimazole in the literature. DILI is a challenging diagnosis and can often mimic many forms of acute and chronic hepatitis. The pattern of liver injury can be hepatocellular, cholestatic, or mixed in nature. The R-value is a useful tool for characterizing the pattern of liver injury, while the Roussel Uclaf Causality Assessment Method (RUCAM) aids with quantifying the likelihood of DILI. The updated version of RUCAM from 2016 was used in this report. We present a case of a 72-year-old female who developed cholestatic DILI secondary to methimazole with a calculated RUCAM score of 8, initially obscured by both imaging and endoscopic findings concerning for hepatobiliary obstruction.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.13042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481564","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}