JGH Open最新文献

{"title":"Management Outcomes of Variceal Bleeding in Northern Tanzania: Insights From a Single-Center Retrospective Analysis","authors":"Eliada B. Nziku,&nbsp;Elifuraha W. Mkwizu,&nbsp;Abid M. Sadiq,&nbsp;Fuad H. Said,&nbsp;Doreen T. Eliah,&nbsp;Ibrahim Ali Ibrahim Muhina,&nbsp;Tumaini E. Mirai,&nbsp;Furaha S. Lyamuya,&nbsp;Nyasatu G. Chamba,&nbsp;Elichilia R. Shao,&nbsp;Kajiru G. Kilonzo,&nbsp;Sarah J. Urasa","doi":"10.1002/jgh3.70088","DOIUrl":"10.1002/jgh3.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Due to the expensiveness and unavailability of endoscopy management in Tanzania, the management outcomes of variceal bleeding are unknown. The objective of this study was to assess the management outcomes of patients with variceal bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective study conducted between April 2012 and April 2022. The study enrolled all patients diagnosed with variceal bleeding aged 18 years and older. Socio-demographic and clinic characteristics, treatment modalities, and outcomes were collected. Statistical analysis was done using a chi-square test. Multivariable logistic regression was used to determine factors associated with rebleeding and mortality. A <i>p</i>-value of ≤ 0.05 was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 534 patients were enrolled based on diagnostic endoscopy findings. Esophageal varices were identified in 88.9% of patients, gastric varices in 0.9%, and 10.1% had both. Conservative treatment was given to 77.5% of patients, and endoscopic treatment was performed in 22.5%: endoscopic variceal ligation (17.6%), endoscopic injection sclerotherapy (4.3%), and both (0.6%). Rebleeding occurred in 40.1%, and factors associated with rebleeding were patients without insurance (<i>p</i> = 0.037), without comorbidities (<i>p</i> = 0.042), with non-communicable diseases (<i>p</i> = 0.039), and with chronic infections (<i>p</i> = 0.035). In-hospital mortality was 8.1%, and factors associated with mortality were a shorter length of stay (<i>p</i> = 0.045), patients without comorbidities (<i>p</i> = 0.041), and grade II esophageal varices (<i>p</i> = 0.043).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study shows a high rate of variceal bleeding among patients treated conservatively. Mortality and rebleeding rates in our setting remain high, which appears to be due to the expensiveness and unavailability of endoscopic treatment. Available endoscopic interventions will be vital in improving the outcomes of patients with variceal bleeding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915919","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":"Ensuring the Future Pool of Gastroenterologists in the United Kingdom Is Imperative","authors":"Hareesha Rishab Bharadwaj,&nbsp;Medha Sridhar Rao,&nbsp;Aditya Gaur,&nbsp;Khabab Abbasher Hussien Mohamed Ahmed,&nbsp;Arkadeep Dhali","doi":"10.1002/jgh3.70084","DOIUrl":"10.1002/jgh3.70084","url":null,"abstract":"<p>This perspective article explores the importance of fostering interest in gastroenterology among medical students and addressing the barriers that deter them from pursuing careers in this specialty. The paper highlights the critical role of early exposure to research, specialized electives, and mentorship in encouraging students to consider gastroenterology as a career choice. Current challenges include limited access to specialized electives and research opportunities within UK medical schools, inadequate hands-on experience, and a perceived lack of stability and control over future training pathways. Additionally, suboptimal working conditions in the National Health Service (NHS) and uncertainty in the allocation of foundation jobs further discourage students from specializing in gastroenterology. To address these issues, the paper proposes several strategies: expanding gastroenterology electives, increasing research opportunities through grassroots initiatives and developing targeted mentorship programs to guide and inspire students. Furthermore, enhancing diversity and representation within the specialty by removing barriers for female medical students is crucial for creating a more inclusive environment. This article combines insights from existing literature, personal experiences, and innovative educational initiatives to provide a comprehensive overview of the current state of gastroenterology training for medical students. The recommendations aim to inspire new approaches to medical education and training that will cultivate a well-prepared, diverse, and motivated workforce ready to advance the field of gastroenterology.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883260","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":"Linkage to Care of People With Chronic Hepatitis B Virus and Hepatitis C Virus Infection Among Blood Donors: Experience From an Apex Treatment Centre Under National Viral Hepatitis Control Program, India","authors":"Sk Mahiuddin Ahammed,&nbsp;Boby Maibam Singh,&nbsp;Swapan Saren,&nbsp;Pratik Dey,&nbsp;Raja Roy,&nbsp;Abhijit Chowdhury","doi":"10.1002/jgh3.70085","DOIUrl":"10.1002/jgh3.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Chronic viral hepatitis is a major public health challenge. The World Health Organization (WHO) and many national programs have set goals for elimination of viral hepatitis by 2030. Screening, Linkage to care (LTC), and access to treatment are very important steps to eliminate viral hepatitis. The study aimed to assess the cascade of chronic viral hepatitis care and the barrier of LTC in the National Viral Hepatitis Control Program (NVHCP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this observational cross-sectional study, healthy voluntary blood donors from two leading blood banks, who were HBsAg or anti-HCV reactive, were advised to attend the clinic of NVHCP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 116 569 healthy blood donors, prevalence of chronic HBV and HCV were 0.5% and 0.2% respectively. LTC was very poor. Only 27.7% HBsAg positive and 8.9% anti HCV positive patients attended NVHCP clinic. However, those who attended the clinic, 87.8% HBV and 100% HCV-infected patients were retained. All HCV patients (<i>n</i> = 16) achieved SVR-12. Among HBV-infected patients, treatment eligibility was 21%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this study, LTC was very poor. Only 27.7% of chronic HBV and 9% of HCV patients attended the NVHCP clinic. Immediate interventions are required to enhance LTC for asymptomatic patients with chronic viral hepatitis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883263","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":"Efficacy of Vonoprazan 10 mg and 20 mg for Patients With Proton Pump Inhibitor-Refractory Functional Dyspepsia: A Double-Blinded, Randomized Study","authors":"Chalermrat Bunchorntavakul,&nbsp;Pantaree Jaigla","doi":"10.1002/jgh3.70082","DOIUrl":"https://doi.org/10.1002/jgh3.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A proportion of patients with functional dyspepsia (FD) have inadequate symptom control with proton pump inhibitors (PPIs) treatment. Vonoprazan demonstrates higher efficacy in acid reduction than PPI; however, the existing efficacy data for vonoprazan in treating PPI-refractory FD is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This double-blinded, randomized controlled trial study was conducted at Rajavithi Hospital, Bangkok between December 2022 and 2023. Patients with FD who were unresponsive to the standard dose PPI were randomly assigned (1:1) to receive either 10 mg or 20 mg of vonoprazan for a 4-week duration, with a subsequent 4-week follow-up after treatment. The primary outcome was changes in the Global Overall Symptoms Scale (GOSS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty patients were randomized without significant differences in baseline characteristics between both groups. The mean GOSS between the 10-mg vonoprazan and the 20-mg vonoprazan arm were 25.73 and 26.17 at week 0, 14.33 and 15.50 at week 2, 9.37 and 10.04 at week 4, and 9.79 and 9.33 at week 8, respectively (all <i>p</i> &lt; 0.001 vs. baseline and <i>p</i> &gt; 0.05 between groups). The quality of life was improved, with the Nepean dyspepsia index changing −4.13 and −4.25 at week 4, respectively (all <i>p</i> &lt; 0.001 vs. baseline; <i>p</i> = 0.853 between groups). Symptom response rates (&gt; 50% improvement in GOSS) were 72.4% and 75.9% at week 8, respectively (<i>p</i> = 0.24 between groups). No serious adverse events were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Vonoprazan demonstrated significant effects in the alleviation of symptoms in PPI-refractory FD patients. There was no statistically significant difference in symptom alleviation between the 10 mg and 20 mg doses of vonoprazan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142868974","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":"Isolated Right Ventricular Metastasis of Hepatocellular Carcinoma: Clinical Findings and Histopathology of an Atypical Presentation","authors":"Aaron Yee Shuen See,&nbsp;Pulkit Kasiviswanathan,&nbsp;Masood Pasha Syed,&nbsp;Marta Minervini,&nbsp;Ibrahim Halil Sahin,&nbsp;Michal Krauze","doi":"10.1002/jgh3.70079","DOIUrl":"https://doi.org/10.1002/jgh3.70079","url":null,"abstract":"<p>Cardiac metastases are a rare site for metastatic hepatocellular carcinoma (HCC). We describe an atypical presentation of an isolated right ventricular metastasis of HCC following successful treatment with no evidence of primary disease recurrence. The case presented as gradually worsening hypertension and erythrocytosis in the setting of normal surveillance scans and alpha-fetoprotein levels. The mass was detected on transthoracic echocardiogram and treated with surgical resection. Histopathological features of the tumor demonstrated features associated with WNT/β-catenin mutated HCC, such as microtrabecular, acinar, and bile staining with positive glutamine synthetase expression.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142868997","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":"Linitis Plastica in a Patient With Previous Breast Cancer: Primary Gastric Cancer or Breast Cancer Metastases?","authors":"Ren Yi Jonas Ho,&nbsp;R Rajesh,&nbsp;Wei Keat Wan,&nbsp;Chang Chuen Mark Cheah,&nbsp;Yi Yuan Tan","doi":"10.1002/jgh3.70071","DOIUrl":"https://doi.org/10.1002/jgh3.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Linitis plastica is a challenging diagnosis in the setting of a patient with previous breast cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>We present a case of a 74-year-old Chinese Female with a history of breast cancer who presented with epigastric pain, nausea, early satiety, and weight loss of 5 kg in 3 months. Endoscopic diagnosis of linitis plastica was made, but subsequent management plans were dependent on accurate histological assessment in view of her oncological history.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and conclusion</h3>\u0000 \u0000 <p>Our case highlights the clinical conundrum confronting the endoscopist in evaluating suspected linitis plastica where the imaging, endoscopic, and macroscopic histological findings between primary gastric adenocarcinoma and metastatic breast cancer can be indistinguishable. Optimal deep tissue acquisition is required to differentiate the true diagnosis in such cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142868930","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":"Exploring the Impact of Gender on the Characteristics and Complications of Eosinophilic Esophagitis","authors":"Het Patel,&nbsp;Joshua Elmer,&nbsp;Hammad Liaquat","doi":"10.1002/jgh3.70059","DOIUrl":"https://doi.org/10.1002/jgh3.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Eosinophilic esophagitis (EoE) is a chronic inflammatory process of the esophagus often associated with structural and motility problems. Previous studies have shown an increased prevalence in males over females, however there is little data exploring the risk of esophageal complications among genders, which may be indicative of differences in disease severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective cohort study using National Inpatient Sample data including adults hospitalized between 2016 and 2020 presenting with EoE. The primary outcome measured was inpatient complications related to the patient's history of EoE and secondary outcomes include demographics, comorbidities, month of presentation, and age of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 21 755 patients with history of EoE, 112 260 (52%) were male and 10 495 (48%) were female. Males had higher rates of several EoE complications, including esophageal obstruction, food bolus, esophageal rupture, requiring esophageal dilation, requiring esophageal laceration repair with <i>p</i> &lt; 0.05 for all. Higher rates of females with EoE were seen in the Black population (<i>p</i> &lt; 0.05). We also found that males were most likely to have esophageal impaction and esophageal rupture in the month of March (<i>p</i> &lt; 0.05). Esophageal impaction was more common in males ages 25–29 (<i>p</i> &lt; 0.05), whereas females were more likely from age 75–79 (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Males have an overall high rate of complication from EoE. There was a higher prevalence of females with EoE in the Black population although the rates of complication remained higher in males in this subpopulation. The month of March carries a risk of esophageal impaction and rupture pronounced particularly in men. Age also appears to have an influence on the rate of esophageal impaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142868973","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":"An epidemiological study on the factors including genetic polymorphism influencing ALT >30 U/L and liver fibrosis progression in metabolic dysfunction-associated steatotic liver disease among the general population","authors":"Satoshi Sato,&nbsp;Chikara Iino,&nbsp;Takafumi Sasada,&nbsp;Go Soma,&nbsp;Keisuke Furusawa,&nbsp;Kenta Yoshida,&nbsp;Kaori Sawada,&nbsp;Tatsuya Mikami,&nbsp;Shinsaku Fukuda,&nbsp;Shigeyuki Nakaji,&nbsp;Hirotake Sakuraba","doi":"10.1002/jgh3.70043","DOIUrl":"https://doi.org/10.1002/jgh3.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Identifying the factors contributing to the progression of metabolic dysfunction-associated steatotic liver disease (MASLD), a lifestyle-related disease, is crucial for preventing future liver-related deaths. This study aimed to epidemiologically investigate factors, including single-nucleotide polymorphisms (SNPs) associated with alanine aminotransferase (ALT) levels &gt;30 U/L and potential risk factors for liver fibrosis, in a general population cohort of patients with MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Among 1059 participants in the health checkup project, 228 who were diagnosed with MASLD were analyzed. Liver fat content and stiffness were measured using FibroScan, and 13 SNPs associated with non-alcoholic fatty liver disease (NAFLD) were measured in addition to other clinical parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the multivariate analysis, male sex, younger age, and high triglyceride levels were significant risk factors for ALT levels &gt;30 U/L (<i>P</i>-value &lt; 0.05). Furthermore, among the 13 SNPs measured, only the GG genotypes of patatin-like phospholipase domain-containing 3 gene (PNPLA3) rs738409 and rs2896019 were significant risk factors for ALT levels &gt;30 U/L (<i>P</i>-value 0.004 and 0.007). The GG genotypes of PNPLA3 rs738409 and rs2896019 had higher FibroScan-aspartate aminotransferase (FAST) and APRI scores than the CC + CG and TT + TG genotypes (<i>P</i>-value &lt; 0.05). In addition, multivariate analysis revealed that the GG genotypes of rs738409 and rs2896019 were significant risk factors independent of cardiovascular metabolic risk for patients with MASLD (<i>P</i>-value 0.038 and 0.021).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>An individualized treatment approach is warranted for patients with MASLD due to the influence of various factors on its progression, including genetic factors and lifestyle diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869003","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":"Extremely dilated intestine","authors":"Jin Li,&nbsp;Xiaoshan Huang,&nbsp;Jiayu Lin,&nbsp;Jian Huang,&nbsp;Wanjie Zhu","doi":"10.1002/jgh3.70050","DOIUrl":"https://doi.org/10.1002/jgh3.70050","url":null,"abstract":"<p>An old woman with severe constipation was dignosed with sigmoid torsion and time-limited surgery was performed to save her life.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851402","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":"Sudden Onset of Intramural Duodenal Hematoma During Hemodialysis in Hypertensive Patient","authors":"Hideaki Kazumori","doi":"10.1002/jgh3.70078","DOIUrl":"10.1002/jgh3.70078","url":null,"abstract":"<p>A 79-year-old man undergoing treatment with warfarin for atrial fibrillation and hemodialysis for renal failure was transferred to our hospital for rehabilitation. During a maintenance hemodialysis session, blood pressure was shown to be elevated and an intramural duodenal hematoma suddenly occurred. After 3 days, the hematoma had enlarged and angiographic embolization was performed, with complete resolution noted after 2 months. Occurrence of an intramural duodenal hematoma during hemodialysis is rare. However, acute abdominal pain with symptoms indicating obstruction in patients undergoing such treatment should raise suspicion regarding an intramural duodenal hematoma. Although conservative treatment is often effective for a nontraumatic intramural hematoma, early angiographic embolization is preferred when disruption of anticoagulant therapy is difficult or for patients with failed medical treatment.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839996","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}