Acta gastro-enterologica Belgica最新文献

{"title":"Preferences and acceptability of telemedicine in Belgian IBD patients.","authors":"K Troch, H Piessevaux, O Dewit","doi":"10.51821/89.1.14704","DOIUrl":"https://doi.org/10.51821/89.1.14704","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammatory bowel diseases (IBD), in particular Crohn's disease (CD) and ulcerative colitis (UC), are chronic conditions that have a considerable impact on patients' quality of life and healthcare resources, as they require frequent visits and hospitalisations. Telemedicine offers a potential advantage by enabling remote healthcare. Studies have shown that telemedicine can improve quality of life and reduce healthcare use, although results vary depending on study design and location. Our study investigates the views of French-speaking Belgian IBD patients on telemedicine. It aims to assess acceptability and preferences to guide future implementation.</p><p><strong>Methods: </strong>We designed a questionnaire available online (between October 2023 and June 2024) for which any patient with IBD followed up in an adult gastroenterology consultation was eligible. The 69-item questionnaire was validated by test patients and distributed via Epic®, social media and printed forms. Data were collected using REDCap® and analyzed using SPSS®, applying univariate and multivariate analyses to identify factors influencing acceptance of telemedicine.</p><p><strong>Results: </strong>257 respondents validated their questionnaire. The majority were women (54%) with an average age of 45 years [17-85]. Most patients had Crohn's disease (63%) and were using immunosuppressive therapy (44%) and/or biologics (30%), with a high compliance rate (98%). Although 68% had discovered telemedicine because of our survey, 82% were interested in remote consultations, citing time savings and reduced absence from work as advantages, while expressing concerns about reduced personal contact and technical problems. Acceptance was significantly associated with time saved and frequency of visits (p<0.05).</p><p><strong>Conclusion: </strong>Our study reveals strong acceptance of telemedicine, regardless of previous experience, with a preference for video over telephone consultations. It also demonstrates openness to follow-up without direct human contact (e.g., application-based tools), although concerns remain about the potential loss of personal interaction. The results underline the importance of addressing patient concerns and ensuring a solid human and technical infrastructure for the expansion of telemedicine.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 1","pages":"55-65"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289110","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}

{"title":"Recurrent gastrointestinal bleeding after Peptide Receptor Radionuclide Therapy for a small intestine neuroendocrine tumor.","authors":"C Brackenier, H Leupe, J Dekervel, C Verslype, G De Hertogh, H Topal, G Rasschaert, C M Deroose, F Van Herpe","doi":"10.51821/89.1.14522","DOIUrl":"https://doi.org/10.51821/89.1.14522","url":null,"abstract":"<p><p>We report a case of a patient who received three cycles of Peptide Receptor Radionuclide Therapy (PRRT) with [177Lu] Lu-DOTATATE for a small intestine neuroendocrine tumor (siNET) and developed recurrent GI (gastrointestinal) bleeding. These complications required four admissions on intensive care unit (ICU), transfusion of fourteen units of packed cells and finally surgery. Radiation safety precautions were respected at all hospital wards. Histopathology of the culprit lesion did not reveal tumor, but showed a large-caliber angiodysplastic lesion. The somatostatin receptor (SSTR) positive tumor consisted of a confluent mass of adenopathies invading the mesenteric vein. We hypothesize the amino-acid infusion, which is supportive therapy given prior to PRRT, caused vasodilatation in the pre-existing angiodysplastic lesion. The vasodilatation together with the high venous pressure due to tumoral invasion of the mesenteric vein may have aggravated bleeding symptoms.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 1","pages":"83-86"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289173","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}

{"title":"Correlating Quality of Life with Point-of-Care Intestinal Ultrasound in Inflammatory Bowel Disease (CUALITY Study).","authors":"V Parra Izquierdo, K Ernest Suarez, M Argollo, J Frías-Ordoñez, G Orduz, F Puentes Manosalva, M Vargas, S Cubillos, E Eggermont, B Verstockt","doi":"10.51821/88.4.14457","DOIUrl":"https://doi.org/10.51821/88.4.14457","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) impacts patients' quality of life (QoL), and hence, there is a need to assess this through patient-reported outcomes (PRO). Intestinal ultrasound (IUS) is a non-invasive tool for monitoring IBD activity, but little is known about its correlation with PRO. This study explored the cross-sectional relationship between PRO, assessed by the IBD Questionnaire-32 (IBDQ-32), and IUS parameters in patients with ulcerative colitis (UC).</p><p><strong>Methods: </strong>This prospective study included 37 Colombian patients with UC. IUS parameters such as bowel wall thickness (BWT), colour Doppler signal (CDS), and mesenteric fat hypertrophy were assessed, followed by IBDQ-32 completion. Two IUS-experienced gastroenterologists, blinded to the IBDQ- 32, performed the assessments.</p><p><strong>Results: </strong>In UC, lower IBDQ-32 scores were significantly correlated with increased BWT (p=0.050), presence of CDS (p=0.022), higher Limberg score (p=0.032), and mesenteric fat hypertrophy (p=0.040). The gastrointestinal and systemic symptom dimensions of the IBDQ-32 showed significant correlations with both BWT (p=0.013 and p=0.013) and CDS (p=0.002 and p=0.003), respectively.</p><p><strong>Conclusions: </strong>In UC, IUS parameters are significantly correlated with quality of life, reinforcing the value of IUS as a point-of-care tool.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 4","pages":"314-322"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145909945","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}

{"title":"Evaluation of Surgical and Conservative Approaches in the Treatment of Anal Fissure: A Systematic Review.","authors":"D Aygin, G Yiğit, A Çelik Bekleviç, E Aydin","doi":"10.51821/88.4.14431","DOIUrl":"10.51821/88.4.14431","url":null,"abstract":"<p><strong>Background and study aims: </strong>Anal fissure is a prevalent condition characterized by severe pain resulting from a tear in the epithelial layer surrounding the anus. This systematic review aims to assess the effectiveness of both surgical and conservative approaches in the management of anal fissures.</p><p><strong>Methods: </strong>A systematic review was conducted, encompassing randomized controlled trials (RCTs), quasi-experimental, and clinical studies published between 2019 and 2024. A comprehensive literature search was performed in Medline, PubMed, and other databases using keywords such as 'anal fissure,' 'sphincterotomy,' and 'topical treatment.' The study adhered to the PICOS framework and followed the PRISMA guidelines. Quality assessment was conducted using the Joanna Briggs Institute (JBI) criteria, and a total of 38 studies were included in the analysis.</p><p><strong>Results: </strong>Of 38 included studies, 27 investigated conservative treatments and 11 evaluated surgical approaches. Conservative methods - particularly topical diltiazem and nifedipine, botulinum toxin injections, and pelvic floor therapy - were effective in pain reduction and healing for many patients and had mostly mild adverse effects. Surgical LIS demonstrated superior long-term healing in refractory cases.</p><p><strong>Conclusions: </strong>Both surgical and conservative approaches serve as complementary strategies in the management of anal fissures. Surgical methods, particularly LIS, provide an effective treatment option with high success rates, while conservative approaches are beneficial in the early stages and for specific patient populations.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 4","pages":"333-350"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145909891","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}

{"title":"Endotipsitis in a liver transplant patient: the role of positron emission tomography in a challenging diagnosis.","authors":"M Lepour, G Dahlqvist","doi":"10.51821/88.4.13774","DOIUrl":"10.51821/88.4.13774","url":null,"abstract":"<p><p>Endotipsitis is a rare but serious infection of TIPSS, with no established diagnostic criteria or treatment guidelines. It presents significant diagnostic challenges, particularly in immunocompromised patients such as liver transplant recipients. We report the case of a patient who underwent liver transplantation followed shortly thereafter by TIPSS placement due to refractory ascites (PSVD of the liver graft). He presented 10 years after with decompensation of cirrhosis and fever. Despite negative blood cultures, FDG PET-CT revealed intense hypermetabolism along the TIPSS suggesting endotipsitis. He was treated initially with antibiotics and required ultimately a liver retransplantation. This case is notable for its occurrence in a transplant recipient, the absence of bacteremia, and the extremely delayed onset after TIPSS placement, the longest interval reported to date. Diagnosis was made through PET-CT, highlighting its critical role when conventional investigations are inconclusive.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 4","pages":"367-370"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145909906","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}

{"title":"Acute pancreatitis in children complicating dyslipidemias: a rare entity in pediatrics.","authors":"S Tizki, S Safadi, K Elmazi, N Baddouh, F El Azzouzi, K Nainia","doi":"10.51821/88.4.14941","DOIUrl":"10.51821/88.4.14941","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis (AP) in children is an uncommon but increasingly recognized medical condition, with dyslipidemias, especially severe hypertriglyceridemia, being a rare etiology. The correlation between primary lipid disorders and AP is rarely documented in pediatrics.</p><p><strong>Objective: </strong>To outline three pediatric cases of acute pancreatitiscomplicated severe hypertriglyceridemia, emphasizing the challenges in diagnosis, treatment approaches, and outcome.</p><p><strong>Cases: </strong>Case 1: A 40-day-old infant with consanguineous parents who was exclusively breastfed showed signs of vomiting and distension in the abdomen. Laboratory analyses indicated triglycerides at 15.6 g/L and lipase at six times the upper limit of normal. Imaging confirmed Balthazar stage C pancreatitis. Management through fasting and intravenous fluids showed clinical improvement. Case 2: A 2-month-old baby had a fever and was vomiting. The lipid panel showed triglycerides at 25.24 g/L, which is a sign of familial hypertriglyceridemia (type IV). The lipase level was high at 498 IU/L, and an ultrasound showed infiltration around the pancreas. Supportive management improved symptoms, but high triglyceride levels required changes in diet and the introduction of fibrates at 2 years of age. Case 3: A 12-year-old with a history of dyslipidemia and recurrent pancreatitis was hospitalized for an episode. Triglycerides rose to 35 g/L, and the lipase level was high. A CT scan showed Balthazar stage C pancreatitis. Treatment included fasting, a special diet, fibrates, and omega-3. The patient had five recurrent episodes over 24 months, despite a brief improvement, primarily as a result of inadequate dietary adherence.</p><p><strong>Conclusion: </strong>These cases reflect that, even though severe hypertriglyceridemia is uncommon in children, it should be considered when making a differential diagnosis of acute pancreatitis, especially if lactescent serum is observed. Age-related dietary limitations and long-term adherence make management challenging.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 4","pages":"351-355"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145909974","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}

{"title":"A virtual-live hybrid training session is feasible with positive impact on colonoscopy key performance indicators amongst trainees.","authors":"L K Debels, L Krott, V Lala, C Schoonjans, L Desomer, J Anderson, R Valori, D J Tate","doi":"10.51821/88.4.14795","DOIUrl":"https://doi.org/10.51821/88.4.14795","url":null,"abstract":"<p><strong>Background: </strong>Colonoscopy is a complex, operator dependent, practical skill. Attainment of key performance indicators (KPIs) by endoscopists depends primarily upon training. Local factors can lead to unstructured training, contingent upon the observed practice of trainers who may not be consciously competent (understand colonoscopy, can identify and deconstruct problems). We sought to demonstrate the feasibility and impact of a virtuallive colonoscopy-training course.</p><p><strong>Methods: </strong>Trainees underwent a one-day training course (intervention) by physically remote, consciously-competent endoscopists, consisting of interactive theoretical and live sessions, where trainees performed colonoscopy in their local endoscopy unit receiving real-time instructions via a teleconference monitor. KPIs (Caecal intubation rate[CIR], adenoma detection rate[ADR], withdrawal time[WT], Gloucester Comfort Score[GCS] and Visual Analog Scale[VAS]) were assessed on trainee-performed colonoscopies for 3 weeks prior and 4 weeks after the intervention. Qualitative trainee and trainer feedback was obtained.</p><p><strong>Results: </strong>6 trainees (mean 654 prior colonoscopies) participated performing 60 colonoscopies (33 pre-, 27 post-intervention). Favourable trends in CIR (91% vs 96%, p=0.386), ADR (39% vs 63%, p=0.069) were observed as well as endoscopist-reported GCS>3 (18% vs 11%, p=0.495) and nurse-reported GCS>3 (22% vs 8%, p=0.131). There was good agreement between trainee- and nurse reported GCS and patient reported VAS. Trainees and trainers reported favourable qualitative experiences.</p><p><strong>Conclusions: </strong>This is the first demonstration of colonoscopy training remotely via teleconference with a positive impact on KPIs. This approach has the potential to create standardized colonoscopy training experiences removing the barriers of travel and allowing exposure to consciously-competent trainers.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 4","pages":"307-315"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145909879","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}

{"title":"Disease course and symptoms in smoking versus non-smoking patients with Celiac disease.","authors":"L Balsiger, A Himmelmann, S R Vavricka, P Schreiner, T Greuter, M Scharl, A M Schoepfer, G Rogler, P H R Green, J Zeitz, L Biederman","doi":"10.51821/88.4.14272","DOIUrl":"https://doi.org/10.51821/88.4.14272","url":null,"abstract":"<p><strong>Background and study aims: </strong>Knowledge about the impact of smoking in Celiac disease is limited. We aimed to assess clinical differences between smoking and non-smoking patients with celiac disease.</p><p><strong>Patients and methods: </strong>We conducted a cross-sectional questionnaire-based study among patients with Celiac disease distributed through a common interest group. Patients answered questions regarding the clinical manifestation of disease, adherence to a gluten-free diet and symptom development over time. Patients were asked whether they smoked at the time of diagnosis. Comparisons to the Swiss General Population were performed using data from the Swiss federal statistic office with data from the health survey 2012.</p><p><strong>Results: </strong>Data on smoking status was available from 1537 individuals. We found a significantly lower proportion of smokers among questionnaire respondents compared to the Swiss general population in the same time frame (8.5% vs 28.2%, p < 0.01). Compared to non-smokers, smokers had a higher age at diagnosis (39 years vs 32 years, p < 0.01) and more frequently reported diarrhea as an initial symptom (67% vs 56%, p =0.013). Smokers tended to adhere less strictly to a gluten-free diet than non-smokers (69% strict adherence vs. 77% p =0.052). Six and twelve months after diagnosis, the proportion of patients with symptomatic improvement was not different between smokers and non-smokers.</p><p><strong>Conclusions: </strong>We found a lower rate of smokers in this large group of celiac disease patients compared to the general population. Differences in presenting symptoms and higher age at diagnosis suggest that smoking might influence disease onset and/or presentation in an early phase.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 4","pages":"301-306"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145909896","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}

{"title":"Auto-Immune Pancreatitis with Pseudo-Tumoral Mass Induced by Pembrolizumab in a Woman suffering from Metastatic Urothelial Carcinoma: Case Report and Literature survey.","authors":"G Bastens, N Bletard, G Matus, F Jehaes, O Plomteux, F Renier, R Materne, B Bastens, C Focan","doi":"10.51821/88.4.14217","DOIUrl":"10.51821/88.4.14217","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy but may induce rare immune-related adverse events including pancreatitis (ICI-PI-), which occurs in 2-4% of cases. Such ICI-PI may necessitate treatment discontinuation. We report the rare case of a 51-year-old female with Lynch syndrome treated with pembrolizumab for metastatic urothelial carcinoma. A pancreatic mass was identified during follow-up by PET/CT. Pathology from endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) could not exclude adenocarcinoma. Surgical resection revealed pathology consistent with type II autoimmune pancreatitis (AIP) in a case which represent by definition , a type III ICI-PI. We explore diagnostic criteria focusing on clinical, serological, histological as well as medical imaging features and management.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 4","pages":"371-374"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145909912","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}

{"title":"Chronic hepatitis E in immunosuppressed patients: a comprehensive review of the literature.","authors":"M Philippart, T Vanwolleghem, G Dahlqvist","doi":"10.51821/88.4.12316","DOIUrl":"https://doi.org/10.51821/88.4.12316","url":null,"abstract":"<p><p>Hepatitis E virus (HEV) is the commonest cause of acute viral hepatitis in Western countries, especially genotypes 3 and 4. Chronic cases are reported in immunosuppressed patients, which includes patients who have undergone solid organ or stem cell transplantation, patients who are being treated for cancer or autoimmune diseases. Chronic HEV can eventually lead to liver fibrosis, and exceptional cases requiring liver transplantation for decompensated liver cirrhosis have been reported. The mechanisms leading to chronic HEV and its incidence in the immunosuppressed population is still unclear due to the paucity of well-designed prospective studies. According to studies conducted in various European countries, the HEV seroprevalence in immunocompromised patients ranges up to 40% and HEV RNA viremic prevalence between 0,5 to 2%. In this review, we provide a description of the epidemiology, risk factors and natural history of chronic HEV in relation to various types of underlying immunosuppressive conditions and discuss the different treatment options available.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 4","pages":"323-332"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145909971","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}