Advances in Digestive Medicine最新文献

{"title":"The accuracy of stool antigen rapid test for diagnosis of Helicobacter pylori infection among different subgroups","authors":"Mei-Jyh Chen,&nbsp;Yu-Jen Fang,&nbsp;Chieh-Chang Chen,&nbsp;Ji-Yuh Lee,&nbsp;Tsung-Hua Yang,&nbsp;Jian-Jyun Yu,&nbsp;Chia-Chi Kuo,&nbsp;Min-Chin Chiu,&nbsp;Ying-Tsang Lu,&nbsp;Ming-Shiang Wu,&nbsp;Jyh-Ming Liou,&nbsp;for the Taiwan Gastrointestinal Disease and Helicobacter Consortium","doi":"10.1002/aid2.70039","DOIUrl":"https://doi.org/10.1002/aid2.70039","url":null,"abstract":"<p>Accurate diagnosis and treatment of <i>Helicobacter pylori</i> (<i>H. pylori</i>) are essential for the optimal prevention of gastric cancer and peptic ulcer disease. While the <i>H. pylori</i> stool rapid test is easy to perform, its diagnostic accuracy among different population groups needs to be thoroughly validated. In this study, we enrolled adult volunteers aged 20 and above to undergo screening for <i>H. pylori</i> infection. Participants underwent serology, ¹³C-urea breath test (UBT), and <i>H. pylori</i> stool antigen test. The one-step stool antigen rapid test was conducted using a commercial HelicotecAG® kit, while <i>H. pylori</i> serology was determined through ELISA. Sensitivity, specificity, and accuracy of the serology and stool antigen tests were calculated using ¹³C-UBT as the reference standard, with subgroup analyses. Logistic regression was employed to identify risk factors associated with untreated <i>H. pylori</i> infection. Between January 2018 and June 2020, 357 adult participants were included. The <i>H. pylori</i> prevalence was higher in symptomatic participants (36.9%–37.5%) compared to asymptomatic subjects (22.3%–28.9%). Sensitivity, specificity, and diagnostic accuracy for the stool antigen rapid test (SAT) were 80.6%, 87.8%, and 85.7%, respectively, and were 87.4%, 90.6%, and 89.6% for serology, respectively. Sensitivity, NPV, and accuracy of SAT were higher in the asymptomatic group compared to the symptomatic group (88.6% versus 74.6%, 96.4% versus 85.4%, and 88.3% versus 82.5%, respectively). Upper abdominal pain and older age were significant risk factors for <i>H. pylori</i> infection in treatment-naïve individuals. The HelicotecAG® stool rapid test is a reliable tool for screening of <i>H. pylori</i> infection. Asymptomatic individuals and those with prior <i>H. pylori</i> eradication were associated with higher test performance.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":"13 2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148533516","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 rare case of gastroduodenal artery pseudoaneurysm-related obstructive jaundice treated by endoscopic ultrasound-guided biliary drainage","authors":"Hsin-Yu Hsu,&nbsp;Chia-Hsien Lin,&nbsp;Yu-Ting Kuo,&nbsp;Hsiu-Po Wang","doi":"10.1002/aid2.70044","DOIUrl":"https://doi.org/10.1002/aid2.70044","url":null,"abstract":"&lt;p&gt;A pseudoaneurysm is defined as an arterial vessel with a defect in at least part of the vessel wall, leading to periarterial contained hematoma formation and an increased risk of rupture. Visceral pseudoaneurysms are often discovered incidentally or present with nonspecific symptoms such as vague abdominal pain, nausea, or vomiting.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; According to previous retrospective studies, atherosclerosis, abdominal trauma, infection/inflammation, and complications of pancreatitis are well-established etiologies for visceral pseudoaneurysms.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In this article, we present a case of 42-year-old man who had a gastroduodenal artery (GDA) pseudoaneurysm at the pancreatic head, initially manifesting as obstructive jaundice and severe abdominal pain. He had been a heavy alcohol consumer for 15–20 years, with a weekly consumption of 20–25 units of alcohol, but denied any history of acute pancreatitis. Upon triage, his vital signs were stable without hypertension. Laboratory data revealed direct-type hyperbilirubinemia, elevated liver enzymes, and marginal leukocytosis. Computed tomography (CT) of the abdomen showed a large tubular structure with adjacent hematoma formation at the pancreatic head, causing dilated intrahepatic and common hepatic duct (Figure 1). Initially, endoscopic retrograde cholangiopancreatography (ERCP) for biliary drainage was performed but failed due to difficult cannulation. Subsequently, percutaneous gallbladder drainage (PTGBD) was performed on the same day. To improve the patient's quality of life, internal biliary drainage via endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) and anterograde biliary drainage was performed 1 week later to replace the external drainage. Under EUS guidance, a 19-gauge needle puncture of the dilated left intrahepatic bile duct, distant from the pseudoaneurysm, can be safely performed (Figure 2A). An anterograde cholangiogram identified an obstruction at the distal common bile duct caused by the pseudoaneurysm (Figure 2B). The pseudoaneurysm was definitively treated by transarterial coil embolization (Figure 2C,D). The total bilirubin level improved afterward (from 14.20 mg/dL to 4.51 mg/dL), and the patient was discharged in stable condition 3 weeks after the initial presentation.&lt;/p&gt;&lt;p&gt;To our knowledge, this is the first reported case demonstrating the successful application of EUS-guided biliary drainage as a salvage treatment after failed ERCP for obstructive jaundice caused by a GDA pseudoaneurysm. Obstructive jaundice caused by external compression of a GDA pseudoaneurysms is extremely rare. The use of EUS-guided biliary drainage by experienced practitioners can serve as a complementary first-line modality to ERCP in patients with obstructive jaundice caused by visceral pseudoaneurysm.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;&lt;b&gt;Hsin-Yu Hsu&lt;/b&gt;: Case data collection and wrote the manuscript. &lt;b&gt;Chia-Hsien Lin&lt;/b&gt;: Case provider and review of the ma","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":"13 2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148532997","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":"Shifting the paradigm in managing low-grade appendiceal mucinous neoplasms: Insights from southern Taiwan","authors":"Hsin-Yu Kuo","doi":"10.1002/aid2.70046","DOIUrl":"https://doi.org/10.1002/aid2.70046","url":null,"abstract":"&lt;p&gt;Low-grade appendiceal mucinous neoplasm (LAMN) represents a unique and clinically perplexing disease entity that has sparked intense debate over the past two decades regarding its nomenclature, pathological classification, and clinical management. Characterized by a villous or flat circumferential proliferation of mucinous epithelium with only low-grade atypia, LAMN notably lacks overtly malignant features such as infiltrative invasion, lymph node involvement, or hematogenous metastasis. Despite this histologically non-aggressive appearance, the true clinical danger of LAMN lies in its potential for mechanical rupture. When a LAMN ruptures, it can cause peritoneal seeding with mucinous tumor implants and the accumulation of gelatinous ascites—a highly morbid condition known as pseudomyxoma peritonei (PMP).&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Historically, appendiceal neoplasms have been documented as incidental findings in less than 1% of routine appendectomies.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; However, in a recent issue of &lt;i&gt;Advances in Digestive Medicine&lt;/i&gt;, Pang et al. shared a single-center experience from a medical center in southern Taiwan that challenges this historical baseline.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Over a 2-year span, the authors identified LAMN in 2.4% (7 out of 289) of all performed appendectomies.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; This notably higher incidence likely reflects the paradigm shift in global and domestic reporting practices. Since January 1, 2022, the Taiwan Cancer Registry Center and the ninth edition of the American Joint Committee on Cancer (AJCC) staging system have officially coded LAMN as 8480/2, designating it as a reportable cancer. This standardizing of nomenclature has moved clinicians away from confusing, archaic terms like “simple mucocele” or “cystadenoma,” thereby unmasking the true, previously underestimated prevalence of this neoplasm.&lt;/p&gt;&lt;p&gt;The primary clinical hurdle highlighted by Pang et al. is the profound diagnostic challenge LAMN presents in day-to-day practice.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Because LAMN often mimics uncomplicated or complicated acute appendicitis, the majority of patients present to the emergency department with acute lower abdominal pain. In emergency settings, the role of screening colonoscopy is inherently limited. However, when colonoscopy is performed in elective or chronic settings, specific endoscopic markers offer critical clues. The presence of a “volcano sign”—characterized by a bulging appendiceal orifice with mucin actively emanating from it—or a submucosal cystic lesion in the cecum should immediately alert the endoscopist to a potential appendiceal mucinous neoplasm, prompting urgent cross-sectional imaging.&lt;/p&gt;&lt;p&gt;In the emergency department, computed tomography (CT) stands out as the most valuable and practical diagnostic tool. The identification of an appendiceal cystic lesion, peri-appendicular phlegmon, or a localized abscess must raise clinical suspicion for LAMN.&lt;span&gt;&lt;sup&gt;4&lt;/","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":"13 2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148532497","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":"Beyond hemorrhagic pancreatitis: Cough-induced abdominal wall hematoma presenting with Cullen and Grey-Turner signs","authors":"Yoen Young Chuah,&nbsp;Yeong Yeh Lee,&nbsp;Ping-Huei Tseng,&nbsp;Hiroshi Kashida,&nbsp;Yow-Ling Shiue","doi":"10.1002/aid2.70041","DOIUrl":"https://doi.org/10.1002/aid2.70041","url":null,"abstract":"<p>An 82-year-old man with a medical history of ischemic stroke, end-stage renal disease on hemodialysis, and long-term aspirin therapy presented with right flank pain for 2 days. He reported severe bouts of coughing due to an upper respiratory tract infection 5 days earlier. Examination revealed ecchymoses over the umbilicus (Cullen sign) (Figure 1A) and the right flank (Grey-Turner sign) (Figure 1B). Laboratory tests included normal amylase (56 U/L), lipase (34 U/L), and coagulation profile (PT: 12.6 s, PTT: 31 s, INR 1.0). Computed tomography revealed no retroperitoneal hemorrhage but demonstrated a hematoma in the right internal oblique muscle, consistent with a cough-induced abdominal wall hematoma (Figure 2, arrow).</p><p>Cullen and Grey-Turner signs are classically associated with hemorrhagic pancreatitis or retroperitoneal bleeding. In acute pancreatitis, the presence of Cullen or Grey-Turner signs indicates severe disease, with mortality rates reported up to 37%.<span>¹</span></p><p>However, this case highlights that cough-induced hematoma may be a less common cause of these signs but is important to recognize.</p><p>In contrast to the classical mechanism of Cullen and Grey-Turner signs caused by retroperitoneal or intra-abdominal hemorrhage tracking along fascial planes, the ecchymoses observed in this case likely represent clinical mimics resulting from a localized abdominal wall hematoma.</p><p>The cause of cough-induced hematoma is not fully understood, but it can be speculated that increased intra-abdominal pressure from severe coughing may have caused shear stress on the muscle that eventually leads to the rupture of small intramuscular vessels in the internal oblique muscle.</p><p>In addition, long-term aspirin therapy and long-term hemodialysis may have further predisposed the patient to bleeding by impairing platelet aggregation and compromising hemostasis.</p><p>Cough-induced abdominal wall hematoma has been reported in the literature, particularly involving the internal oblique muscle or rectus sheath, especially in elderly patients or those receiving antiplatelet therapy.<span>^2-4</span></p><p>The simultaneous presence of intramuscular hematoma and cutaneous ecchymosis mimicking Cullen and Grey-Turner signs is rarely illustrated in the literature and represents the key educational value of this case image.</p><p>Hence, not every occurrence of Cullen and Grey-Turner signs indicates retroperitoneal hemorrhage, as illustrated in this case.</p><p>This study received research funding (PS114011 and PS115010) from Ping Tung Christian Hospital Research Fund.</p><p>The authors declare no conflicts of interest.</p><p>Informed consent was obtained from the patient for the publication of their information and imaging.</p><p>The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":"13 2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148532998","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":"Therapeutic potential of natural compounds in inflammatory bowel disease","authors":"Rashmi Arora,&nbsp;Manju Jakhar,&nbsp;Saurav Singla,&nbsp;Vineeta Rohilla,&nbsp;Nidhi Rani,&nbsp;Ritchu Babbar,&nbsp;Thakur Gurjeet Singh","doi":"10.1002/aid2.70034","DOIUrl":"https://doi.org/10.1002/aid2.70034","url":null,"abstract":"<p>These days, a wide range of diseases are thought to be primarily caused by chronic inflammation. Anti-inflammatory medications are therefore frequently used in conventional therapy for inflammatory conditions; however, several drugs have undesirable side effects. Natural products are viable substitutes that may yield novel bioactive chemicals that could serve as lead molecules for novel anti-inflammatory drugs. An abundant supply of new chemicals can be found in marine environments due to their vast biological and chemical diversity. Some of the major chemical components from marine species, including sesquiterpenoids, diterpenes, steroids, polysaccharides, alkaloids, fatty acids, and proteins, have been extracted and reported to be anti-inflammatory. An emphasis on previous and recent pre-clinical and clinical research updates on marine natural communities and their synthetic congeners with possible anti-inflammatory properties is compiled in this review.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":"13 2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148533525","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":"Obscure upper gastrointestinal bleeding in a jaundice case","authors":"Pi-Hsien Wen,&nbsp;Hau-Jyun Su,&nbsp;Ming-Chang Tsai,&nbsp;Yu-Ting Yu,&nbsp;Chi-Chih Wang","doi":"10.1002/aid2.70045","DOIUrl":"https://doi.org/10.1002/aid2.70045","url":null,"abstract":"<p>A 55-year-old woman had a past history of Sjogren's syndrome and autoimmune hepatitis, which was diagnosed by liver biopsy 10 days before. She went to our emergency department due to right upper quadrant (RUQ) abdominal pain with radiation to the back. She also experienced intermittent tarry stool but denied fever, chills, nausea, or any trauma event. Physical examination revealed RUQ abdominal tenderness, without rebounding pain or Murphy's sign. Laboratory investigation was significant for elevated alanine aminotransferase (58 IU/L), gamma-GT (214 IU/L), total and direct bilirubin (4.97/3.43 mg/dL). The hemoglobin level (12.3 g/dL), platelet count (269 000/μL) and coagulation function (PT: 12.3 s, APTT: 40.3 s) were normal. Abdominal Computed Tomography (CT) showed a high attenuation lesion inside the gallbladder and obvious common bile duct (CBD) dilatation (Figure 1A) compared to previous CT before liver biopsy (Figure 1B), at which time no gallbladder stone nor biliary tract dilatation were noticed 10 days ago.</p><p>Endoscopic ultrasound (EUS) was arranged due to suspicious of periampullary lesion but failed because of swelling of duodenal wall and much blood clots inside. Esophagogastroduodenoscopy showed oozing and blood clots at second portion of duodenum (Figure 1C). A repeat EUS revealed some amorphous echogenic substance with normal size CBD (Figure 2A). Endoscopic retrograde cholangiopancreatography (ERCP) revealed mild distal CBD narrowing and an amorphous filling defect (Figure 2B). Endoscopic sphincterotomy was performed and some blood clots were extracted without visible stone (Figure 2C). The pathology report of periampullary biopsy showed no malignancy, confirming the diagnosis of hemobilia.</p><p>The classic triad presentation of RUQ pain, jaundice, and upper gastrointestinal bleeding, known as the ‘Quincke triad’ of hemobilia, is rarely seen. Hemobilia from percutaneous liver biopsy, causing bile duct obstruction, is much rarer (3% of complications).<span>¹</span> Traditionally, angiography is the gold standard for diagnosis of hemobilia. However, ERCP is increasingly used for both bleeding and biliary obstruction management.<span>^{2, 3}</span></p><p>The authors declare no conflicts of interest.</p><p>Written informed consent was obtained for the patient to publish this article and images. Ethics committee approval is not necessary because this is a case image report. Nonetheless, the authors followed the principles of the Declaration of Helsinki throughout the writing process.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":"13 2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522952","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":"The impact of chronic alcohol consumption on hepatocellular carcinoma: Insights from a cohort study in eastern Taiwan","authors":"Ping-Jen Hu,&nbsp;Chia Yu Pai,&nbsp;Yen-Hsiang Wang,&nbsp;Ming-Yao Chen,&nbsp;Chun-Han Cheng,&nbsp;Huan-Lin Chen,&nbsp;I-Tsung Lin,&nbsp;Chia-Hsien Wu,&nbsp;Yuan-Kai Lee,&nbsp;Po-Wei Huang,&nbsp;Ming-Jong Bair","doi":"10.1002/aid2.70030","DOIUrl":"https://doi.org/10.1002/aid2.70030","url":null,"abstract":"<p>Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, with alcohol-related liver disease (ALD) increasingly recognized as a significant but underexplored risk factor. While chronic hepatitis B (HBV) and hepatitis C (HCV) infections remain the primary etiologies of HCC in Taiwan, the independent impact of alcohol consumption on disease progression and survival outcomes warrants further investigation. This retrospective cohort study analyzed 513 HCC patients from Taitung MacKay Memorial Hospital, a region with a high prevalence of alcohol consumption. Patients were stratified based on alcohol intake and viral hepatitis status, and survival outcomes were assessed using logistic regression and Kaplan–Meier survival analysis. The definition of long-term moderate alcohol consumption is characterized as a daily intake exceeding one standard drink (10–15 g of alcohol) for women and two standard drinks (20–30 g of alcohol) for men, sustained for a minimum duration of 10 years. Our findings revealed that alcohol-related HCC was associated with significantly higher total bilirubin levels (2.39 ± 3.59 mg/dL vs. 1.43 ± 1.27 mg/dL, <i>p</i> = .007). When analyzed as an independent factor, alcohol consumption was linked to a significantly worse prognosis at 2, 3, and 5 years (OR: 0.447, 95% CI: 0.231–0.864 at 5 years). Male patients exhibited a higher risk of HCC development and poorer long-term survival compared to females, while older age was significantly correlated with reduced five-year survival. Hypoalbuminemia (OR: 2.343, 95% CI: 1.422–3.861), elevated platelet count (OR: 0.996, 95% CI: 0.993–0.999), and prolonged prothrombin time (PT) (OR: 0.123, 95% CI: 0.016–0.964) were identified as significant predictors of poor survival outcomes at 2 years. Interestingly, body mass index (BMI), total bilirubin, and hemoglobin levels were not significantly associated with survival. These findings highlight the distinct clinical characteristics and poorer prognosis of alcohol-related HCC, underscoring the need for early identification and personalized treatment strategies for high-risk populations. Integrating albumin levels, platelet count, and PT into routine clinical assessments may enhance prognostic evaluation and inform therapeutic decision-making in HCC management.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":"13 2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148533429","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 prognostic differences in colorectal cancer (2015–2023): The impact of tumor location and stage at diagnosis","authors":"Yen-Ju Chen,&nbsp;Shih-Fang Ou,&nbsp;Ling-Hui Lin,&nbsp;Yang-Cheng Lee,&nbsp;Yin-I Chiu,&nbsp;Kuo-Kuan Chang","doi":"10.1002/aid2.70038","DOIUrl":"https://doi.org/10.1002/aid2.70038","url":null,"abstract":"<p>Colorectal cancer (CRC) is the third most common cancer worldwide, accounting for nearly 0.9 million deaths in 2022. Since the disease typically becomes symptomatic only at an advanced stage, health organizations are implementing organized screening programs globally to improve early detection and reduce both morbidity and mortality associated with CRC. This study aimed to investigate the baseline clinical characteristics of patients with early- and advanced-stage CRC and to evaluate prognosis based on the primary tumor site and diagnostic stage. We conducted a retrospective study utilizing comprehensive cancer registry data, focusing on gastrointestinal cancer cases diagnosed between 2015 and 2023. After implementing a series of exclusion and screening processes, we identified 925 patients with CRC for further analysis. SPSS version 24.0 was used to perform statistical analysis, with a <i>p</i> value of less than .05 considered statistically significant. Over half of the CRC patients were male (541/917, 59.0%) and were diagnosed at an older age (≥66 years). The three most common primary tumor locations were the rectum (284/917, 31.0%), sigmoid colon (247/917, 26.9%), and ascending colon (119/917, 13.0%). Only 5.3% of CRC patients (49/917) received neoadjuvant radio- or chemotherapy to downstage the tumor before surgery. Regardless of cancer stage, nearly 86% of the CRC patients (788/917, 85.9%) ultimately underwent surgery to remove their primary tumor. It is noteworthy that more than 10% of CRC patients (113/916, 12.3%) may experience a recurrence of cancer within an average of 1.7 ± 1.3 years after diagnosis. As is generally expected, the survival time following a cancer diagnosis decreases as the disease progresses, while the risk of cancer recurrence increases. This study revealed that male (hazard ratio [HR] = 2.2, 95% confidence interval [CI] = 1.0–4.6), obesity (HR = 1.9, 95% CI = 1.0–3.8), invasion of peripheral nerve tissue (HR = 3.1, 95% CI = 1.6–6.2), and the number of invaded lymph nodes (HR = 14.5, 95% CI = 4.3–48.7) may influence cancer recurrence. In recent years, a noticeable trend of CRC has shifted in younger individuals. Rapid changes in socioeconomic and lifestyle habits are believed to contribute significantly to the increasing incidence of CRC. Encouraging high-risk groups to actively participate in CRC screening, using fecal occult blood testing as an initial screening tool while emphasizing the importance of a thorough colonoscopy.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":"13 2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148533521","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":"Sclerosing angiomatoid nodular transformation of the spleen","authors":"Yu-Hung Lin,&nbsp;Ruey-Chang Lin,&nbsp;I-Hsun Lin","doi":"10.1002/aid2.70043","DOIUrl":"https://doi.org/10.1002/aid2.70043","url":null,"abstract":"<p>A 45-year-old man with no known underlying disease presented with left upper quadrant pain for 2 weeks. There were no other symptoms such as fever or night sweats. X-ray of KUB found calcified lesions over left upper abdomen (Figure 1A). Ultrasound of abdomen showed multiple mixed-echoic tumors of the spleen. Further abdominal computed tomography showed multiple contrast-enhanced spleen masses. A “spoke wheel” pattern and peripheral enhancement around the spleen lesion were seen during the arterial phase on further magnetic resonance imaging (MRI) (Figure 1B).</p><p>An endoscopy of the upper and lower gastrointestinal tract revealed no malignancy. The role of surgery is to confirm the correct diagnosis and to exclude the suspicion of malignancy. A surgical consultation was requested to evaluate the incidentally found splenic mass. Laparoscopic splenectomy was performed without complication afterward. The pathological report of splenectomy confirmed the spleen lesion as sclerosing angiomatoid nodular transformation (SANT) (Figure 2).</p><p>The patient remained asymptomatic with no evidence of recurrence over the two-year follow-up period.</p><p>SANT is a rare benign non-neoplastic vascular splenic lesion that was first reported by Martel et al.<span>¹</span> It usually occurs in middle-aged adults as an incidental finding on imaging. The differential diagnosis of SANT includes both benign tumors and malignant vascular lesions such as splenic hamartomas, hemangiomas, littoral cell angiomas, angiosarcoma, lymphoma, and myeloma.<span>²</span></p><p>Classical feature of SANT on a postcontrast CT is described as a hypovascular splenic mass with enhancing rim and peripheral enhancing radiating lines towards center of the mass, known as the “spoke-wheel” pattern.<span>³</span></p><p>Preoperatively diagnosing SANT based on fine needle aspiration cytology was debatable.<span>⁴</span></p><p>Albeit this lesion has characteristic radiological findings on both CT and MRI scans, it may pose a difficulty in distinguishing this rare benign entity from other lesions of the spleen both clinically and radiologically. The conventional treatment for SANT involves splenectomy, which is both therapeutic and diagnostic.</p><p>The authors declare no conflicts of interest.</p><p>Written informed consent was obtained from the patient.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":"13 2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148533682","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":"Low grade appendiceal mucinous neoplasm: A single center experience in southern Taiwan","authors":"Mai-Gio Pang,&nbsp;Pei-Lun Lee,&nbsp;Cheng-Heng Lin,&nbsp;Tang-Wei Chuang,&nbsp;Chun-Ta Cheng,&nbsp;Chien-Hung Chen,&nbsp;Yan-Chung Wang,&nbsp;Hung-Da Tung,&nbsp;Jyh-Jou Chen","doi":"10.1002/aid2.70035","DOIUrl":"https://doi.org/10.1002/aid2.70035","url":null,"abstract":"<p>Low grade appendiceal mucinous neoplasms (LAMN) were characterized by a villous or flat circumferential proliferation of mucinous epithelium with low grade atypia and lack of overtly malignant features and abundant mucin production. However, if left untreated and ruptured, LAMN can lead to intraperitoneal accumulation of gelatinous ascites and mucinous tumor implants, a condition known as pseudomyxoma peritonei (PMP), which carries significant morbidity and mortality. Early diagnosis and appropriate treatment of LAMN are crucial to reduce risk of tumor rupture and progression to PMP. This case series comprised of seven cases of LAMN, including two cases with PMP, within a 2-year span of a single center in Southern Taiwan. The clinical presentations, imaging studies, diagnoses and managements were summarized and analyzed to delineate LAMN and PMP.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":"13 2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148533526","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}