Acta gastro-enterologica Belgica最新文献_第10页

Biliary papillomatosis. 胆道乳头状瘤病。

IF 1.5 4区医学

Acta gastro-enterologica Belgica Pub Date : 2023-07-01 DOI: 10.51821/86.3.11733

F Gelders, M Struyve, H van Malenstein

引用次数: 0

Editorial. 社论

IF 1.5 4区医学

Acta gastro-enterologica Belgica Pub Date : 2023-07-01 DOI: 10.51821/86.3.12360

C Reenaers, H De Schepper

引用次数: 0

An unusual cause of portal hypertension. 门静脉高压的一个不寻常的原因。

IF 1.5 4区医学

Acta gastro-enterologica Belgica Pub Date : 2023-07-01 DOI: 10.51821/86.3.11925

K Ferdinande, T Lamiroy, A Hoorens, X Verhelst, H Degroote, S Raevens, H Van Vlierberghe, A Geerts

{"title":"An unusual cause of portal hypertension.","authors":"K Ferdinande, T Lamiroy, A Hoorens, X Verhelst, H Degroote, S Raevens, H Van Vlierberghe, A Geerts","doi":"10.51821/86.3.11925","DOIUrl":"10.51821/86.3.11925","url":null,"abstract":"A 66-year-old male with a medical history of coronary artery disease presented with nonspecific symptoms of anorexia, lethargy and an increase in abdominal girth. He was diagnosed 3 months ago with chronic liver disease of undetermined aetiology. He did not smoke and was a social drinker till 4 months ago. He was taking tests showed progressive cholestatic liver enzymes (total bilirubin 1,09 mg/dL, AST 130 U/L, ALT 129 U/L, GGT 517 U/L and ALP 641 U/L) and a severe hypoalbuminemia. Laboratory workup made a metabolic, autoimmune, and viral aetiology of the suspected cirrhosis less probable. Urinalysis showed a rapidly progressive proteinuria in the nephrotic range accompanied by the presence of serum spike of monoclonal lambda light Furosemide, Aldactone, Pantoprazole, Acetylcysteine and Atorvastatin. He had no personal or familial history of liver diseases. Physical examination revealed a tender but distended abdomen and large ascites was present. The laboratory chain protein on electrophoresis with immunofixation. Doppler echocardiography revealed a hypertrophic cardiomyopathy based on diffuse left and right ventricular hypertrophy with relative apical sparing. A diagnostic paracentesis was undertaken and the results were consistent with portal hypertension (SAAG 1,6 g/ dL). Considering the concomitant presence of hypertrophic cardiomyopathy, nephrotic syndrome and a presentation of portal hypertension of undetermined aetiology in presence of a monoclonal IgG lambda light chain spike, a transjugular liver biopsy (figure 1 and 2) was performed with HVPG measurement consistent with significant portal hypertension (15 mmHg).","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"86 3","pages":"509-510"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EUS-guided transrectal drainage of pelvic abscesses: a retrospective analysis of 17 patients. EUS引导下经直肠引流治疗盆腔脓肿：17例患者的回顾性分析。

IF 1.5 4区医学

Acta gastro-enterologica Belgica Pub Date : 2023-07-01 DOI: 10.51821/86.3.12029

H Peeters, M Simoens, J Lenz

{"title":"EUS-guided transrectal drainage of pelvic abscesses: a retrospective analysis of 17 patients.","authors":"H Peeters, M Simoens, J Lenz","doi":"10.51821/86.3.12029","DOIUrl":"10.51821/86.3.12029","url":null,"abstract":"Background: Pelvic abscess is a common complication of abdominal surgery or intestinal or gynecological diseases. Over the last decades, endoscopic ultrasound (EUS)-guided drainage has emerged as a minimally invasive alternative to percutaneous or surgical treatment of pelvic abscesses.Aim: To evaluate safety and efficacy of EUS-guided transrectal pelvic abscess drainage in a single center.Methods: From February 2017 to April 2023, all data on patients who were treated for pelvic abscesses by EUS-guided drainage in a single center, were retrospectively analyzed.Results: A total of 17 patients were treated for pelvic abscesses by EUS-guided drainage. The procedure was technically successful and uneventful in all 17 patients (100%). Etiology of the abscess was postsurgical (n=5, 29%), secondary to medical illness (n=10, 59%) or gastrointestinal perforation (n=2, 12%). The abscess was multilocular in 5 patients (29%), the mean largest diameter was 76 mm (range 40-146 mm). Drainage was performed using 2 double pigtail stents, and in 1 patient an additional 10 Fr drainage catheter was deployed. Two patients (12%) required a second endoscopic intervention. Treatment success, defined by complete abscess resolution on follow-up CT scan along with symptom relief, was 100%. There was no need for surgical intervention. The median post-procedural hospital stay was 5 days. No recurrence was reported within a median time of follow-up of 39 months.Conclusion: EUS-guided transrectal drainage of pelvic abscesses using double pigtail stents is safe and highly effective. This case series contributes to the cumulative evidence that, in expert hands, EUS-guided drainage should be considered as first-line approach for treatment of pelvic abscesses.","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"86 3","pages":"395-400"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment of recurrent Clostridioides difficile infections with faecal microbiota transplantation: peri-procedural methods in a consecutive case series. 粪便微生物群移植治疗复发性艰难梭菌感染：连续病例系列的围手术期方法。

IF 1.5 4区医学

Acta gastro-enterologica Belgica Pub Date : 2023-07-01 DOI: 10.51821/86.3.11795

K Korpak, L Defourny, S Lali, M Delvallée, R Demeester, E Toussaint

{"title":"Treatment of recurrent Clostridioides difficile infections with faecal microbiota transplantation: peri-procedural methods in a consecutive case series.","authors":"K Korpak, L Defourny, S Lali, M Delvallée, R Demeester, E Toussaint","doi":"10.51821/86.3.11795","DOIUrl":"10.51821/86.3.11795","url":null,"abstract":"Background: Faecal microbiota transplantation (FMT) has high efficacy against recurrent Clostridioides difficile infection (CDI). Despite the increasing use of this therapy, the delay between diagnosis and treatment is excessive. Furthermore, donor selection is an important and time-consuming process.Methods: We reviewed patients who underwent FMT for recurrent CDI at the CHU Charleroi Hospital between 2015 and 2022. The general context, type of administration, adverse events, and donor selection were reported. FMT was conducted using gastroduodenoscopy, colonoscopy, and enema with either fresh or frozen material.Results: Ten patients with multiple comorbidities were treated by FMT. Seven patients were cured after one procedure. One patient was successfully cured after a change to an unrelated donor, and preliminary efficacy was established.Conclusions: FMT is an effective treatment that should be considered during the earlier phases of treatment. Stool donors should be thoroughly screened for infectious diseases and other criteria related to microbiota composition.","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"86 3","pages":"486-489"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

What do we know today about drug-induced microscopic colitis? A case of lymphocytic colitis on olmesartan. 我们今天对药物诱导的显微镜下结肠炎了解多少？奥美沙坦治疗淋巴细胞性结肠炎1例。

IF 1.5 4区医学

Acta gastro-enterologica Belgica Pub Date : 2023-07-01 DOI: 10.51821/86.3.11361

A Djembissi Fotso, M Arvanitakis, M Salame, J Gallez, A Lakis

{"title":"What do we know today about drug-induced microscopic colitis? A case of lymphocytic colitis on olmesartan.","authors":"A Djembissi Fotso, M Arvanitakis, M Salame, J Gallez, A Lakis","doi":"10.51821/86.3.11361","DOIUrl":"10.51821/86.3.11361","url":null,"abstract":"Microscopic colitis is part of the differential diagnosis of chronic watery diarrhea. Colonoscopy discloses a normal looking mucosa, therefore its diagnosis is based on histology of colonic biopsies. Two main phenotypes are distinguished: collagenous colitis and lymphocytic colitis. A third entity, incomplete microscopic colitis or unspecified microscopic colitis has been reported in the literature. It affects preferentially women over 60 years of age and its association with certain drugs is increasingly established. In case of suspected drug-induced microscopic colitis, identification of the responsible drug is a key to management. After discontinuation of the suspected drug, the gold standard of treatment is budesonide both for induction and for maintenance in case of clinical relapse, as is often the case after discontinuation. Therapy with immunomodulators, biologics, or surgery is reserved for refractory forms of microscopic colitis after multidisciplinary consultation. Through the clinical case of colitis on olmesartan, we will review the latest recommendations on drug-induced microscopic colitis.","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"86 3","pages":"474-480"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tofacitinib, celiac disease and the elderly: mind the gut! 托法替尼、乳糜泻和老年人：注意肠道！

IF 1.5 4区医学

Acta gastro-enterologica Belgica Pub Date : 2023-07-01 DOI: 10.51821/86.3.12207

N Boutrid, H Rahmoune

{"title":"Tofacitinib, celiac disease and the elderly: mind the gut!","authors":"N Boutrid, H Rahmoune","doi":"10.51821/86.3.12207","DOIUrl":"10.51821/86.3.12207","url":null,"abstract":"To the Editor, We read with great attention the interesting case report by Lenfant et al. narrating the successful use of tofacitinib in a patient with microscopic colitis and celiac disease (1), and we would point some insights about this peculiar situation. In fact, tofacitinib depicts potential side effects, including a higher risk of malignancies, and the FDA has even issued a warning about this drug’s hazard (2). Actually, a randomized open-label trial published in the New England Journal of Medicine in 2021 found that patients with rheumatoid arthritis who took tofacitinib had a higher risk of developing cancer than those who took a tumor necrosis factor (TNF) inhibitor (3). Recently, two recent randmoized controlled trials from the ORAL Surveillance Trial and published in the Annals of the Rheumatic Diseases in 2023 also contributed to shed the light on this potential risk : that patients with rheumatoid arthritis aged > 50 with cardiovascular risk who took tofacitinib had a higher risk of developing any type of cancer than those who took a TNF inhibitor (4), and secondary stratification found that they were more likely to develop cancer if they were over the age of 65 years (5). Adding insult to injury, the maligancies are also driven by the two peculiar forms of celiac disease : seronegative and refractory celiac disease (RCD), and this risk is also increased in CD diagnosed at adulthood : particularly, elder patients are prone to present a RCD, and giving immune checkpoint therapy might increase this risk (6). In conclusion, RCD ought to be definetly ruled out before starting JAK inhibitor therapy, especially in aged population with seronegative celiac disease and microscopic colitis, two well-known conditions associated with RCD.","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"86 3","pages":"502"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dumping syndrome after bariatric surgery: prevalence, pathophysiology and role in weight reduction - a systematic review. 减肥手术后的倾倒综合征：患病率、病理生理学和在减肥中的作用——一项系统综述。

IF 1.5 4区医学

Acta gastro-enterologica Belgica Pub Date : 2023-07-01 DOI: 10.51821/86.3.11476

A D'hoedt, T Vanuytsel

{"title":"Dumping syndrome after bariatric surgery: prevalence, pathophysiology and role in weight reduction - a systematic review.","authors":"A D'hoedt, T Vanuytsel","doi":"10.51821/86.3.11476","DOIUrl":"10.51821/86.3.11476","url":null,"abstract":"Background: Dumping syndrome is a frequent and wellknown adverse event after bariatric surgery and covers a dynamic spectrum of early and late dumping. Accelerated gastric emptying is generally considered to be the cause of gastrointestinal and vasomotor complaints. However, there is much uncertainty regarding the exact pathophysiology of dumping. It has been speculated that the syndrome is a desired consequence of bariatric surgery and contributes to more efficient weight loss, but supporting data are scarce.Methods: A systematic search was conducted in PubMed in July-August 2021. The prevalence of dumping after the most frequently performed bariatric procedures was analyzed, as well as underlying pathophysiology and its role in weight reduction.Results: Roux-en-Y gastric bypass (RYGB) is associated with the highest postoperative prevalence of dumping. The fast transit induces neurohumoral changes which contribute to an imbalance between postprandial glucose and insulin levels, resulting in hypoglycemia which is the hallmark of late dumping. Early dumping can, when received in a positive way, become a tool to maintain a strict dietary pattern, but no significant relationship to the degree of weight loss has been shown. However, late dumping is detrimental and promotes overall higher caloric intake.Conclusion: Dumping syndrome is common after bariatric surgery, especially after RYGB. The pathophysiology is complex and ambiguous. Currently available data do not support dumping as a necessary condition to induce weight loss after bariatric surgery.","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"86 3","pages":"417-427"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A remarkable presentation of a massive Budd-Chiari syndrome. 一个巨大的布-加综合征的显著表现。

IF 1.5 4区医学

Acta gastro-enterologica Belgica Pub Date : 2023-07-01 DOI: 10.51821/86.3.11994

K Ferdinande, H Degroote, A Geerts, H Van Vlierberghe, X Verhelst, S Raevens

{"title":"A remarkable presentation of a massive Budd-Chiari syndrome.","authors":"K Ferdinande, H Degroote, A Geerts, H Van Vlierberghe, X Verhelst, S Raevens","doi":"10.51821/86.3.11994","DOIUrl":"10.51821/86.3.11994","url":null,"abstract":"A 59-year-old female presented to the emergency department with malaise, significant weight loss, abdominal discomfort, dyspnoea and severely swollen peripheral extremities. She had a past medical history of sickle cell anaemia, a latent tuberculosis infection and a chronic hepatitis B that was treated with PEG-interferon alpha-2 in 2008. Since 2018, she was lost to follow-up. The patient was critically ill, sarcopenic and lethargic. Clinical examination revealed icteric sclerae and a markedly distended and diffusely tender abdomen and peripheral oedemas. Her vital signs included a blood pressure of 105/64 mmHg, tachycardia of 130 bpm, hypothermia of 35.6°C and a SpO2 of 100% in ambient air. Laboratory workup demonstrated a total bilirubin of 12.9 mg/dL, AST 500 U/L, ALT 218 U/L, ALP 178 U/L and GGT 126 U/L, a thrombocytopenia of 34 x10E3/ μL, 16,01 x10E3/μL leukocytes, a CRP of 94.8 mg/L and a lactate of 10,12 mmol/L. The serum creatinine was 1.04 mg/dL, eGFR 54.1 ml/min. The INR was 2.77 and there was a severe hypoalbuminemia (22 g/L). D-dimers were >20 000 ng/ml. The patient presented also with spontaneous hypoglycaemia. A multiphasic contrast-enhanced thoracic and abdominal computed tomography (CT) was performed (figure 1). Given the results of the CT, a 2D echocardiogram was urgently requested (figure 2).","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"86 3","pages":"503-504"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tofacitinib for celiac disease and microscopic colitis: killing two birds with one stone. 托法替尼治疗乳糜泻和显微镜下结肠炎：一举两得。

IF 1.5 4区医学

Acta gastro-enterologica Belgica Pub Date : 2023-04-01 DOI: 10.51821/86.2.11639

M Lenfant, G De Hertogh, B Verstockt

引用次数: 2