Annals of Gastroenterology最新文献

{"title":"Clinical features and outcomes of total pancreatic lipomatosis with chronic pancreatitis: a case series.","authors":"Surinder Singh Rana, Sanish Ancil, Sachin Hosahally Jayanna, Mandeep Kang, Rajesh Gupta","doi":"10.20524/aog.2025.0939","DOIUrl":"10.20524/aog.2025.0939","url":null,"abstract":"<p><strong>Background: </strong>Fatty changes in the pancreas are common, whereas total pancreatic lipomatosis (PL) is rare. Commonly associated with various components of metabolic syndrome and metabolic-associated steatotic liver disease, total PL can have various etiologies and can manifest with severe pancreatic exocrine insufficiency.</p><p><strong>Method: </strong>We retrospectively analysed the clinical profile and management outcomes of 8 patients (mean age: 37.1 years; 5 male) with total PL seen at a tertiary care center over the last 15 years.</p><p><strong>Results: </strong>All patients presented with abdominal pain and had coexistent chronic pancreatitis, while 5/8 (62%) patients had metabolic syndrome. None of the patients had a history of acute pancreatitis or congenital syndromes, nor developed pancreatic carcinoma in the follow up. Seven (87%) patients had pancreatic ductal dilatation and calcification. All patients had pancreatic exocrine insufficiency, while 5/8 (52%) patients had endocrine insufficiency. Six (75%) patients were successfully managed with pancreatic endotherapy.</p><p><strong>Conclusions: </strong>Pancreatic endotherapy is safe and effective in the treatment of abdominal pain in patients who have chronic pancreatitis with total PL. These patients have a high frequency of pancreatic exocrine as well as endocrine insufficiency.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 1","pages":"100-104"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969009","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":"Authors' reply.","authors":"Thanathip Suenghataiphorn, Pojsakorn Danpanichkul, Tuntanut Lohawatcharagul","doi":"10.20524/aog.2024.0938","DOIUrl":"10.20524/aog.2024.0938","url":null,"abstract":"","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 1","pages":"105"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142968847","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":"Diagnostic approach to patients with suspected motility disorders: one size does not fit all.","authors":"Theodoros Voulgaris, Theodoros Alexopoulos, Jiannis Vlachogiannakos, Dimitrios Kamberoglou, George Papatheodoridis, George Karamanolis","doi":"10.20524/aog.2025.0941","DOIUrl":"10.20524/aog.2025.0941","url":null,"abstract":"<p><strong>Background: </strong>Dysphagia and retrosternal chest pain are considered typical manifestations of major esophageal motility disorders (mEMD). High-resolution manometry (HRM) is the gold standard for mEMD diagnosis, while endoscopy and barium swallow are ancillary tools. We aimed to investigate the frequency of mEMD among patients referred for HRM with typical compared to non-typical symptoms. We also evaluated endoscopic and barium swallow data from patients with mEMD who underwent HRM.</p><p><strong>Methods: </strong>We retrospectively collected epidemiological, endoscopic, barium swallow, and HRM data from 302 patients. Atypical symptoms were considered to be heartburn, regurgitation, globus, oropharyngeal dysphagia, and epigastric pain.</p><p><strong>Results: </strong>The main referral symptoms were: esophageal dysphagia, 58.3%; chest pain, 13.7%; heartburn, 8.9%; regurgitation, 8.3%; and globus/oropharyngeal dysphagia/epigastric pain, 10.8%. A diagnosis of mEMD was more common when typical symptoms existed (69.9% vs. 15.4%, P<0.001). The majority of patients with mEMD in HRM, independently of their symptoms, had an abnormal barium study (typical: 94.8% vs. non-typical: 100%, P=0.633), while compatible endoscopic data tended to be observed more frequently among patients with typical symptoms (69.1% vs. 40%, P=0.057). An HRM diagnosis of mEMD among patients with compatible findings from either barium swallow or endoscopic examination was statistically more frequent among patients with typical symptoms (92.4% vs. 52.6%, P<0.001).</p><p><strong>Conclusions: </strong>More than half of patients referred for HRM will be diagnosed with mEMD, at a higher rate when typical symptoms are reported. A lack of compatible endoscopic and barium swallow findings, in the absence of typical symptoms, makes the diagnosis of mEMD almost impossible.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 1","pages":"12-19"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969316","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":"Impact of pericarditis on cardiovascular complications and healthcare utilization in patients with inflammatory bowel disease: a National Inpatient Sample study.","authors":"Ayushi Garg, Rohan Menon, Ajit Brar, Hunza Chaudhary, Aalam Sohal, Avneet Kaur, Vijaywant Singh Brar","doi":"10.20524/aog.2024.0931","DOIUrl":"10.20524/aog.2024.0931","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD), which affects over 2.3 million people in the USA, involves chronic gut inflammation and can lead to cardiovascular complications, including pericarditis. Whether pericarditis in IBD patients is caused by medication, or by the disease itself, remains unclear. Our study aimed to determine the prevalence of pericarditis in IBD and its impact on cardiac complications, outcomes and resource utilization.</p><p><strong>Methods: </strong>NIS data were obtained for IBD patients from 2016-2020. Outcomes were assessed using multivariate logistic regression, adjusting for demographics, hospital characteristics, comorbidities, and IBD etiology.</p><p><strong>Results: </strong>In our study of 1.52 million IBD patients, 0.6% had pericarditis, of whom a majority were women (54.1%) and white (76.3%), over 65 years old (43.1%), enrolled in Medicare (51.7%), and living in urban areas (96.3%). Adjusting for confounding factors, IBD patients with pericarditis had higher odds of cardiac arrest (adjusted odds ratio [aOR] 2.73, 95% confidence interval [CI] 1.90-3.91), cardiogenic shock (aOR 6.42, 95%CI 4.77-8.64), and ventricular arrhythmia (aOR 2.13, 95%CI 1.63-2.78 (P<0.001 for all).</p><p><strong>Conclusions: </strong>Our study found that pericarditis, though rare at 0.6%, significantly impacts cardiovascular health and healthcare utilization in IBD patients, with higher prevalence of pericarditis in older individuals, females, and those with comorbidities such as diabetes, hypertension or chronic kidney disease highlighting the need for further research to enhance therapeutic approaches and patient care.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 1","pages":"51-59"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969349","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":"Landscape of B lymphocytes and plasma cells in digestive tract carcinomas.","authors":"Konstantina Dimopoulou, Dina Tiniakos, Nikolaos Arkadopoulos, Periklis G Foukas","doi":"10.20524/aog.2024.0936","DOIUrl":"10.20524/aog.2024.0936","url":null,"abstract":"<p><p>Digestive tract carcinomas are the most commonly occurring cancers worldwide, but their prognosis with traditional treatments remains poor. T lymphocytes are well-recognized as crucial components of effective anti-tumor immunity, and current immunotherapeutic strategies concentrate mainly on T-cell-mediated immunity reinforcement, whereas the role of B lymphocytes and plasma cells (PCs) has been neglected in the past, and it is only recently that these cells have been considered as key players in the tumor microenvironment (TME). In this review, we describe the complex dual role of B lymphocytes and PCs in promoting and inhibiting tumor progression in the TME of digestive tract carcinomas, and we demonstrate their prognostic value. Furthermore, we highlight their controversial function in cancer and nominate them as additional therapeutic targets for the development of new treatment interventions that might alter the dismal prognosis of digestive tract tumors.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 1","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969266","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":"Immune checkpoint inhibitor-associated gastrointestinal adverse events in patients with colorectal cancer.","authors":"Antonio Pizuorno Machado, Saltenat Moghaddam Adames, Malek Shatila, Parvir Aujla, Ryan Huey, Yinghong Wang, Anusha Thomas","doi":"10.20524/aog.2024.0935","DOIUrl":"10.20524/aog.2024.0935","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICI) target microsatellite instability-high (MSI-H) tumors with success. The incidence and characteristics of ICI-related colitis (IMC) in patients with MSI-H colorectal cancers (CRC) are unclear.</p><p><strong>Methods: </strong>We performed a retrospective analysis of adult patients with CRC who received ICI between June 1, 2014, and December 31, 2022, including data on IMC observed up to 3 months after the last dose of ICI. Patients' demographics, oncologic profile, endoscopic features, treatment and clinical outcomes were evaluated.</p><p><strong>Results: </strong>Of 474 patients with CRC receiving ICI during our study period, 18 developed IMC (3.8%). The majority were Caucasian (88.8%), male (61.1%), and their median age was 69.5 years. Of these patients, 50% received combination therapy with anti-PD-1/L1 and CTLA-4; 66.6% had MSI-H colorectal cancer, 11.1% had a second cancer-melanoma, while 61.2% and 66.7% had grade 1-2 colitis and diarrhea respectively. Endoscopic evaluation was used in 5 patients, of whom 2 had ulcerative inflammation necessitating selective immunosuppressive therapy with biologics. Therapy was withheld in 61.1% because of toxicity; 41.4% and 5.8% were noted to have median Common Terminology Criteria for Adverse Events grade 2 liver and pancreas toxicity respectively. The majority of our cohort received steroid therapy.</p><p><strong>Conclusions: </strong>The lower severity of IMC, compared to toxicity in other ICI-treated cancers, may be influenced by the tumor microenvironment in MSI-H colorectal cancer after ICI exposure. Larger prospective studies are necessary to determine the role of tumor biology and the gut microbiome in the disease profile and severity of IMC.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 1","pages":"72-79"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969339","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":"Impact of aspirin on pancreatic cancer.","authors":"Christos Zavos","doi":"10.20524/aog.2024.0937","DOIUrl":"10.20524/aog.2024.0937","url":null,"abstract":"","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 1","pages":"105"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969345","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":"Validation of gender-equity model for liver allocation (GEMA) and its sodium variant (GEMA-Na) in candidates for liver transplantation.","authors":"Magdalini Adamantou, Theodora Oikonomou, Nedia Georgia Petridou, Panagiotis Kalligiannakis, Christos Chologkitas, Michail Kalpoutzakis, Maria Christina Kavalaki, Dimitrios Glaros, Evangelinos Michelis, Apostolos Papageorgiou, George V Papatheodoridis, Ioannis Goulis, Evangelos Cholongitas","doi":"10.20524/aog.2024.0933","DOIUrl":"10.20524/aog.2024.0933","url":null,"abstract":"<p><strong>Background: </strong>The current allocation system for liver transplantation (LT) is based on the sickest-first policy, using objective variables to ensure equal priority. However, under-prioritization of female patients for LT, compared to males, is well demonstrated and new scores have been proposed to overcome this systematic bias. This study evaluated the ability of these new scores to predict the long-term outcomes of patients with cirrhosis.</p><p><strong>Methods: </strong>The clinical and laboratory characteristics of 694 consecutive candidates for liver transplantation from 2 liver transplant centers were recorded. The model for end-stage liver disease (MELD)-based scores (MELD, MELD-Sodium and MELD 3.0), as well as the Gender-Equity Model for liver Allocation (GEMA) and GEMA-Sodium, were used to assess the severity of liver disease. Patients were followed-up prospectively and their outcomes assessed.</p><p><strong>Results: </strong>During a follow-up period of median length 12 months (range: 4-52), 28.5% of patients died, 21% of patients underwent LT, while 50.5% remained alive. Female patients had significantly lower MELD and MELD-Sodium scores compared to males, attributable to their significantly lower creatinine, while MELD 3.0, GEMA and GEMA-Sodium did not differ between the 2 sexes. In multivariate Cox regression analysis, GEMA-Sodium was the only factor independently associated with death/LT, and showed very good discriminative ability (hazard ratio 1.10, 95% confidence interval 1.073-1.128; P<0.001). These findings were confirmed in several subgroup analyses.</p><p><strong>Conclusions: </strong>Our findings show for the first time the predictive ability of GEMA-Sodium for the long-term outcomes of LT candidates. However, further studies are needed to confirm these findings.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 1","pages":"93-99"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969357","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":"Endoscopic management of ileal pouch-anal anastomosis strictures: meta-analysis and systematic literature review.","authors":"Parth Patel, Manav Patel, Mohamad Ayman Ebrahim, Priyadarshini Loganathan, Douglas G Adler","doi":"10.20524/aog.2024.0929","DOIUrl":"10.20524/aog.2024.0929","url":null,"abstract":"<p><strong>Background: </strong>Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is a common surgical procedure for ulcerative colitis and familial adenomatous polyposis. IPAA strictures are a known complication, often requiring surgical intervention. Endoscopic interventions offer a less invasive alternative, but their safety and efficacy remain uncertain.</p><p><strong>Methods: </strong>A comprehensive literature search was performed to identify pertinent studies. Outcomes assessed were technical success, clinical success (immediate and end of follow up), pouch failure rate and adverse events. Pooled estimates were calculated using random effects models with a 95% confidence interval.</p><p><strong>Results: </strong>A total of 607 patients from 9 studies were included. Technical success, defined as the ability to pass the endoscope through the stricture, was achieved in 97.4% of patients. Immediate clinical success, defined as symptom improvement post-intervention, was seen in 44.5% of patients. Clinical success at the end of follow up was observed in 81.7% of patients. However, 6.8% of patients experienced pouch failure and ultimately 14.5% required surgical intervention for refractory strictures or complications. Endoscopic intervention-related serious adverse events occurred in 3.9% of patients, including perforation and major post-procedural bleeding.</p><p><strong>Conclusions: </strong>Endoscopic interventions for IPAA strictures demonstrate high technical success rates, providing a less invasive option for managing this complication. While clinical success rates immediately post-procedure and at end of follow up are promising, a significant proportion of patients ultimately require surgical intervention for pouch failure or refractory strictures.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 1","pages":"60-67"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969256","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":"Use of artificial intelligence for the detection of <i>Helicobacter pylori</i> infection from upper gastrointestinal endoscopy images: an updated systematic review and meta-analysis.","authors":"Om Parkash, Abhishek Lal, Tushar Subash, Ujala Sultan, Hasan Nawaz Tahir, Zahra Hoodbhoy, Shiyam Sundar, Jai Kumar Das","doi":"10.20524/aog.2024.0913","DOIUrl":"10.20524/aog.2024.0913","url":null,"abstract":"<p><strong>Background: </strong><i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is associated with various gastrointestinal diseases and may lead to gastric cancer. Currently, endoscopy is the gold standard modality used for diagnosing <i>H. pylori</i> infection, but it lacks objective indicators and requires expert interpretation. In the past few years, the use of artificial intelligence (AI) for diagnosing gastrointestinal pathologies has increased tremendously and may improve the diagnostic accuracy of endoscopy for <i>H. pylori</i> infection. This study aimed to evaluate the diagnostic accuracy of AI algorithms for detecting <i>H</i>. <i>pylori</i> infection using endoscopic images.</p><p><strong>Methods: </strong>Three investigators searched the PubMed, CINHAL and Cochrane databases for studies that compared AI algorithms with endoscopic histopathology for diagnosing <i>H. pylori</i> infection using endoscopic images. We assessed the methodological quality of studies using the QUADAS-2 tool and performed a meta-analysis to estimate the pooled sensitivity, specificity, and accuracy of AI for detecting <i>H. pylori</i> infection.</p><p><strong>Results: </strong>A total of 11 studies were identified that met our inclusion criteria. All were conducted in different countries based in Asia. Our meta-analysis showed that AI had high sensitivity (0.93, 95% confidence interval [CI] 0.90-0.95), specificity (0.92, 95%CI 0.89-0.94), and accuracy (0.92, 95%CI 0.90-0.94) for detecting <i>H. pylori</i> infection using endoscopic images. However, there was also high heterogeneity among the studies (Tau²=0.87, <i>I</i> ²=76.10% for generalized effect size; Tau²=1.53, <i>I</i> ²=80.72% for sensitivity; Tau²=0.57, <i>I</i> ²=70.86% for specificity).</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis showed that AI had high diagnostic accuracy for detecting <i>H. pylori</i> infection using endoscopic images.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"37 6","pages":"665-673"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680683","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}