Acta gastro-enterologica Belgica最新文献

{"title":"Mortality and rebleeding rate of Dieulafoy lesions throughout the gastrointestinal tract.","authors":"H Döngelli, E Yalçin, S Dolu, G Bengi","doi":"10.51821/88.1.13762","DOIUrl":"10.51821/88.1.13762","url":null,"abstract":"<p><strong>Background/objectives: </strong>Dieulafoy lesion (DL) is a rare yet potentially life-threatening cause of gastrointestinal bleeding. This study retrospectively analyzed all patients diagnosed with DL over the past two decades, focusing on clinical outcomes such as rebleeding and mortality. We aimed to identify factors associated with these outcomes to improve the understanding and management of this condition.</p><p><strong>Materials/methods: </strong>This study included 39 hospitalized patients who underwent endoscopy for gastrointestinal bleeding and were diagnosed with Dieulafoy lesions. Data were collected retrospectively, and regression analysis was performed to assess factors associated with all-cause mortality and rebleeding rates.</p><p><strong>Results: </strong>The study included 39 patients, with a mean age of 64 years; 13 (33%) were women. The most common presenting complaint was hematemesis (41%). The most common localization of DLs was the stomach, with 25 (64.1%) DLs detected. Rebleeding rates within one week and mortality within 90 days were 33% and 28%, respectively. In univariate analysis, esophageal localization (HR: 3.398, p = 0.042), low hemoglobin levels (HR: 0.758, p = 0.030), and high Glasgow- Blatchford score (HR: 1.179, p = 0.035) were associated with rebleeding. Duodenal localization was independently associated with higher mortality (HR: 27.276, p < 0.001), after adjusting for age, sex, and comorbidity index.</p><p><strong>Conclusion: </strong>Dieulafoy lesions are most commonly found in the stomach but can also occur in atypical sites like the jejunum or hernia pouch. Enteroscopy is crucial for diagnosing and treating DLs, especially those in atypical small intestine locations. Lesion localization plays a key role in predicting both rebleeding and mortality rates.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"109-117"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273863","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":"Post-transplantation lymphoproliferative disorder (PTLD) with rectal involvement.","authors":"K Mombaerts, J-B Zeevaert, B Feytmans, M Vivario","doi":"10.51821/88.1.13641","DOIUrl":"https://doi.org/10.51821/88.1.13641","url":null,"abstract":"","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"215-216"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273864","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":"Atypical presentation of Olmesartan-induced gastritis and enteropathy.","authors":"H Schreurs, C Breynaert, G De Hertogh, L Wauters","doi":"10.51821/88.1.13942","DOIUrl":"10.51821/88.1.13942","url":null,"abstract":"<p><p>Olmesartan is an angiotensin II receptor blocker (ARB) used for the management of hypertension. We report a case of Olmesartan-associated severe gastritis and enteropathy (OAE) in a 81-year-old female patient who presented with anorexia and weight loss. After discontinuation of the drug, her symptoms improved and follow-up gastroscopy showed endoscopic improvement. Histopathology showed a reduction of eosinophils and intraepithelial lymphocytosis, but a persisting increase in mast cells. Hence, systemic mastocytosis was excluded by further investigations. To our knowledge, this is the first case report of a patient with Olmesartan-associated severe gastritis with histopathological presence of mast cells. We conclude that mast cells, like eosinophils, could be druginduced, although systemic mastocytosis must be ruled out. Future studies should focus on the link between local mast cells and gastro-intestinal diseases.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"203-206"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273941","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":"Balloon Dilation-assisted Extraction of Embedded Self-Expandable Metal Stents.","authors":"M Bronswijk, A Reekmans, S van der Merwe","doi":"10.51821/88.1.14150","DOIUrl":"10.51821/88.1.14150","url":null,"abstract":"<p><strong>Background and study aims: </strong>Embedded transpapillary self-expandable metal stents (SEMS) may require extraction over time and standard approaches often fail. In the current study we describe a newly developed approach to refractory embedded SEMS, using balloon dilation-assisted extraction. Our aim was to evaluate the feasibility and outcomes of this novel technique.</p><p><strong>Patients and methods: </strong>This is an exploratory single-center retrospective analysis of all consecutive patients undergoing endoscopic balloon-assisted stent extraction. Baseline, procedural and follow-up data were collected and analyzed.</p><p><strong>Results: </strong>Twelve patients with embedded transpapillary SEMS were identified (60.0% female, mean age 70.1 [SD±18.1] years, uncovered SEMS 33.3%) with median dwell time of 457.5 (IQR 175.8-1042) days. Previous extraction attempts were undertaken in the majority of cases (83.3%), including SEMS-in-SEMS placement (41.7%). Using the balloon-assisted stent extraction technique, successful SEMS extraction was achieved in 10 out of 12 cases (83.3%). Adverse events occurred in 3 patients (Grade II [n=2, 16.7%] - Grade III [n=1, 8.3%]). After a median follow-up time of 171 (58-260) days, 1 biliary recurrence occurred for which endoscopic re-evaluation was performed.</p><p><strong>Conclusions: </strong>Our data suggest that endoscopic balloonassisted stent extraction should be considered for extraction of embedded self-expandable metal stents, as it showed high efficacy without any major procedure-related adverse events, using readily available endoscopic tools.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"103-108"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273942","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":"Belgian consensus on the management of patients with functional dyspepsia.","authors":"S Kindt, J Arts, P Caenepeel, F de Clerck, H De Schepper, H Louis, P Latour, T Mahler, S Nullens, H Piessevaux, K Routhiaux, J Schol, M Surmont, H Vafa, C Van de Bruaene, K Van Malderen, T Vanuytsel, L Wauters, F Wuestenberghs, J Tack","doi":"10.51821/88.1.14136","DOIUrl":"10.51821/88.1.14136","url":null,"abstract":"<p><strong>Background: </strong>Functional dyspepsia (FD) is a disorder of gutbrain interaction characterised by epigastric pain, epigastric burning, early satiation or postprandial fullness. Despite its high prevalence, clinicians struggle with the diagnosis and management of these patients.</p><p><strong>Methods: </strong>A Delphi consensus was conducted by 20 experts from Belgium, and consisted of a literature review, summarising the existing evidence, and a voting process on 119 statements. Grading of recommendations, assessment, development and evaluation criteria were applied to evaluate the quality of evidence. Consensus was defined as > 80 % agreement.</p><p><strong>Results: </strong>Belgian consensus underlines the multifactorial aetiology of FD. In addition to the cardinal symptoms, bloating and weight loss are also observed in FD. Functional dyspepsia co-exists with other DGBIs, including IBS. Subtyping based on the postprandial nature of symptoms is recommended. Patients should receive a positive diagnosis. Additional testing is not routinely required before initiating therapy, except in the presence of alarm features or treatment-refractory symptoms, and can consist of upper GI endoscopy, abdominal imaging and gastric emptying testing. The consensus refuted the role of carbohydrate malabsorption testing, pyloric impedance planimetry, pH/impedance monitoring, food allergy testing and permeability testing in FD. Explanation and reassurance, also addressing lifestyle factors, represent the cornerstone of the management. Proton Pump Inhibitors are considered the firstline pharmacological treatment. With the exception of specific neuromodulators, the panel did not achieve consensus for other therapeutic options. This consensus recommends against restrictive diets, invasive endoscopic or surgical treatment, parenteral nutrition, antibiotics, spasmolytics and opioids in the management of FD.</p><p><strong>Conclusion: </strong>A panel of Belgian experts summarised the existing evidence on the aetiology, presentation, diagnosis and treatment of FD with attention to the availability within the Belgian healthcare system. Areas of future research are identified.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"157-178"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273943","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":"Clinical analysis of ultrasound-guided warm saline enema in the treatment of pediatric intussusception.","authors":"Jiankang Guo, Yanhong Bai, You Liang, Ya-Na Liu, Bin Zhang, Zhigang Fan","doi":"10.51821/88.1.13622","DOIUrl":"10.51821/88.1.13622","url":null,"abstract":"<p><strong>Objective: </strong>Few studies have explored using ultrasound-guided warm saline enema to treat acute intussusception in children. This article aimed to assess the effect of warm saline enema on acute intussusception in children.</p><p><strong>Methods: </strong>In this study, we retrospectively analyzed 169 children who underwent ultrasound-guided warm saline enema treatment for pediatric intussusception in 3201 Hospital, Shanxi, China between January 1, 2020, and December 31, 2022.</p><p><strong>Results: </strong>Out of the 169 children included in the study, 156 were successfully treated, while 13 did not respond to the treatment. The success rate was 92.31%, and the failure rate was 7.69%. The reduction time and hospital stay in 169 children ranged from 9 to 54 minutes and 1 to 25 days, respectively. On average, the reduction process took about 20.84±4.86 minutes, and the hospital stay was around 3.79±2.49 days. Among the 169 children, 3 experienced nausea and vomiting, while none had postoperative diarrhea or intestinal perforation. The overall incidence of complications like nausea and vomiting was 1.78%.</p><p><strong>Conclusions: </strong>A total of 169 children with intussusception underwent treatment using ultrasound-guided warm saline enema. The reduction time was consistent with the existing literature. Complications were small in these cases, only manifested as nausea and vomiting. These findings also provide valuable evidence for clinical management of these diseases.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"97-102"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273857","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 slobbering appendix.","authors":"C Collin, J-P Loly","doi":"10.51821/88.1.14237","DOIUrl":"https://doi.org/10.51821/88.1.14237","url":null,"abstract":"","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"219-220"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273938","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":"Indirect calorimetry in canopy mode in healthy subjects: performances of the Q-NRG device compared to the Deltatrac II.","authors":"M Fadeur, J F Kaux, J De Flines, B Misset, N Paquot, A F Rousseau","doi":"10.51821/88.1.13301","DOIUrl":"10.51821/88.1.13301","url":null,"abstract":"<p><strong>Background: </strong>Extensive validation of the Q-NRG indirect calorimeter in canopy mode, especially against reference devices, is lacking. The aim of this study was to test its agreement in canopy mode with the Deltratrac II, which has always been considered as the gold standard indirect calorimeter in daily practice.</p><p><strong>Methods: </strong>Healthy volunteers underwent indirect calorimetry with two consecutive assessments, using Q-NRG and Deltatrac II, both in canopy mode, in a random order, after careful calibrations. Body position, fasting conditions and environment were standardized. Agreement between the two devices was evaluated by paired Student's t test, correlation coefficients, and Bland-Altman plots.</p><p><strong>Results: </strong>Sixty-one adults (85.2% male, aged 25.7±8.4 y, BMI 23.3±2.9 kg/m2) were included. Measured energy expenditure was similar whether it was measured using Q-NRG or Deltatrac II: 1816±361 kcal/day or 1809±260 kcal/day (p=0.803), respectively. There was a significant positive correlation between the two measures (ρ=0.78, p= <0.01). The Q-NRG slightly overestimated the energy expenditure compared to the Deltatrac II measure: the bias ± limits of agreement was 7 ± 227 kcal/day.</p><p><strong>Conclusion: </strong>In healthy volunteers breathing spontaneously, the Q-NRG in canopy mode performed similarly to the Deltatrac II for energy expenditure measurement. The present study confirms the previously demonstrated accuracy of the Q-NRG device, and supports its clinical use in canopy mode.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 1","pages":"13-17"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439694","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":"Precision imaging in chronic liver disease management.","authors":"Maxime Nachit","doi":"10.51821/88.1.14128","DOIUrl":"10.51821/88.1.14128","url":null,"abstract":"<p><p>Metabolic dysfunction-associated fatty liver disease (MAFLD) affects over a quarter of the global population, with up to 30% developing Metabolic Dysfunction-Associated Steatohepatitis (MASH), a progressive form that can silently lead to fibrosis, cirrhosis, and liver cancer. Current diagnostic methods, including blood-based scores and imaging, are insufficient for early detection, leading to late-stage diagnoses in most patients. Liver biopsy remains the diagnostic gold standard but is invasive, costly, and prone to high inter- and intra-reader variability, limiting its utility in routine care and clinical trials. Our research highlights myosteatosis-fat infiltration in skeletal muscle-as a potential early, non-invasive marker of MASH. In preclinical models and clinical studies, myosteatosis correlated with the presence of MASH and distinguished it from isolated steatosis. Notably, reductions in myosteatosis following interventions such as bariatric surgery or dietary regimens were associated with histological improvements in MASH, suggesting a potential role in predicting treatment response. In larger cohorts, myosteatosis was identified as a strong predictor of all-cause mortality. In parallel, we utilized a VCAM- 1-targeted molecular imaging technique and demonstrated a high accuracy in detecting inflammation in preclinical MASH models. This technology is now advancing to clinical trials for validation in humans. Taken together, our data support that targeted medical imaging may enable early, non-invasive diagnosis and monitoring of MASH, reducing reliance on liver biopsy and improving patient outcomes.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 1","pages":"61-66"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439671","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":"Decision making in technical evaluation and treatment of pelvic floor multidisciplinary team discussion. Will multidisciplinary team discussion change policy?","authors":"C Steger, S Vanden Broeck, H De Schepper","doi":"10.51821/88.1.13210","DOIUrl":"10.51821/88.1.13210","url":null,"abstract":"<p><p>Pelvic floor multidisciplinary team (MDT) discussion is emerging as a standard part of care for patients with pelvic floor disorders. Although its use is encouraged by guidelines, there is still a lack of solid evidence supporting its benefits. The aim of this study is to evaluate the impact of pelvic floor MDT discussions on the diagnostic approach and treatment of a patient population at Antwerp University Hospital. After reviewing 26 patient cases, the study demonstrated a change in technical investigations in 69% of cases and a change in diagnostics in 85% of cases. These findings indicate that pelvic floor MDT discussions have a significant impact on both the diagnostic and treatment approaches for pelvic floor disorders.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 1","pages":"31-37"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439661","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}