DEN open最新文献

{"title":"Evaluation of a novel contrast-enhanced fluoroscopy protocol for endoscopic retrograde cholangiopancreatography in a phantom model (with video)","authors":"Takaoki Hayakawa,&nbsp;Masayasu Horibe,&nbsp;Eisuke Iwasaki,&nbsp;Fateh Bazerbachi,&nbsp;Yuki Suno,&nbsp;Tsubasa Sato,&nbsp;Haruka Okada,&nbsp;Yuki Nakajima,&nbsp;Yosuke Mizukami,&nbsp;Atsuto Kayashima,&nbsp;Takashi Seino,&nbsp;Shintaro Kawasaki,&nbsp;Takanori Kanai","doi":"10.1002/deo2.70087","DOIUrl":"https://doi.org/10.1002/deo2.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study evaluated a novel contrast-enhanced (CE) fluoroscopy protocol for endoscopic retrograde cholangiopancreatography, which optimizes image processing to enhance contrast of devices and contrast media. We compared the CE protocol with the conventional standard protocol to assess its potential for reducing radiation exposure while improving image visibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study utilized a multidirectional fluoroscopy unit and phantoms to evaluate the new CE protocol against the conventional protocol. Comparisons included radiation dose rates, spatial resolution, and concentration resolution under various fluoroscopic conditions. The investigation aimed to determine if the CE protocol offered improved visibility while potentially reducing radiation exposure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three CE protocol modes (LOW-7.5 fps, MID-3.75 fps, and LOW-3.75 fps) achieved lower dose rates than the standard MID-7.5 fps mode commonly used in clinical practice. Dynamic spatial resolution was significantly superior in all three CE modes compared to the standard protocol (<i>p</i> &lt; 0.0167). Static spatial resolution did not differ significantly between protocols. Only the CE MID-3.75 fps mode showed superior concentration resolution compared to the standard protocol (<i>p</i> &lt; 0.00833).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The novel CE fluoroscopy protocol provides superior dynamic spatial resolution in endoscopic retrograde cholangiopancreatopgraphy while reducing radiation exposure, potentially enhancing procedure guidance and safety for both patients and clinicians.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475417","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":"Oxygen saturation imaging elucidates tumor heterogeneity in gastric cancer","authors":"Tatsunori Minamide,&nbsp;Nobuhisa Minakata,&nbsp;Riu Yamashita,&nbsp;Shingo Sakashita,&nbsp;Yusuke Yoda,&nbsp;Akihiro Ohashi,&nbsp;Masato Aoshima,&nbsp;Susumu Kobayashi,&nbsp;Tomonori Yano","doi":"10.1002/deo2.70077","DOIUrl":"https://doi.org/10.1002/deo2.70077","url":null,"abstract":"<p>Oxygen saturation imaging is a new technology that determines biological features from the perspective of oxygen concentration. Therefore, this exploratory study aimed to evaluate the biological implications of oxygen saturation imaging and further assess tumor heterogeneity in gastric cancer. Biopsy samples were selectively obtained from treatment-naïve patients with gastric cancer under real-time oxygen saturation imaging. Tissue oxygen saturation level calculations, immunohistochemistry, and RNA sequencing were performed. The mean tissue oxygen saturation levels at the sampling sites were 32.2%, 70.8%, and 56.2% for hypoxic, hyperoxic, and non-tumor areas, respectively, with significant differences between each pair. CD-31 and glucose transporter 1 protein expression were significantly upregulated in hypoxic tumors. Comprehensive transcriptomic analysis revealed enriched biological processes related to the regulation of insulin-like growth factor transport and uptake by insulin-like growth factor-binding proteins in hypoxic tumors and the type I interferon signaling pathway in hyperoxic tumors. Oxygen saturation imaging has the potential to clarify hypoxia-induced heterogeneity in gastric cancer from both clinical and fundamental perspectives.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455917","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 case of recurrent gastric volvulus successfully treated with nasogastric tube-assisted endoscopic reduction and percutaneous endoscopy-assisted gastropexy","authors":"Ryuji Katoh,&nbsp;Eriko Katoh,&nbsp;Hironori Tatsuki,&nbsp;Fumiyoshi Saito,&nbsp;Masahiko Motegi,&nbsp;Kiyotaka Osawa,&nbsp;Hiroshi Saeki","doi":"10.1002/deo2.70079","DOIUrl":"https://doi.org/10.1002/deo2.70079","url":null,"abstract":"<p>We report the case of a 97-year-old male with recurrent gastric volvulus who was successfully treated with nasogastric tube-assisted endoscopic reduction followed by percutaneous endoscopy-assisted gastropexy with gastric wall fixation. The nasogastric tube facilitates endoscopic reduction by enhancing the procedure's efficiency. In contrast, percutaneous endoscopy-assisted gastropexy provides an effective, minimally invasive method to prevent the recurrence of gastric volvulus, even in patients with poor overall health. This case highlights the clinical utility of these combined approaches in managing gastric volvulus in elderly patients with significant comorbidities.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455916","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":"Surrounding superficial esophageal cancer masked by Candida esophagitis that was difficult to distinguish from Candida esophagitis alone: A case report","authors":"Shunsuke Takahashi,&nbsp;Mitsuhiro Kono,&nbsp;Yasuhiro Fujiwar","doi":"10.1002/deo2.70080","DOIUrl":"https://doi.org/10.1002/deo2.70080","url":null,"abstract":"<p>During the initial diagnosis of superficial esophageal squamous cell carcinoma, a 70-year-old man was treated with endoscopic submucosal dissection (ESD). Two years after the first ESD, follow-up endoscopy revealed that the extent of hyperkeratosis gradually expanded over the following 4 years; however, biopsies conducted only detected <i>Candida</i> mycelia and no cancer at that time and every 6 months for 4 years. Despite initiating fluconazole treatment for persistent <i>Candida</i> esophagitis 6 years after the first ESD, the lesions did not resolve, and the second ESD was performed 6 years after the first ESD, which revealed squamous cell carcinoma. This case highlights that esophageal cancer should be considered when localized, hyperkeratotic <i>Candida</i> esophagitis is unresponsive to antifungal treatments, especially with a history of esophageal cancer or high-risk factors such as drinking alcohol and smoking.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423735","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":"Factors associated with delayed bleeding following ampullectomy: A retrospective cohort study","authors":"Katarzyna M. Pawlak,&nbsp;Kareem Khalaf,&nbsp;Sunil Gupta,&nbsp;Daniel Tham,&nbsp;Joseph Chon,&nbsp;Ahmed H. Mokhtar,&nbsp;Caleb Na,&nbsp;Maryam Mahjoob,&nbsp;David M.P. Di Fonzo,&nbsp;Jeffrey D. Mosko,&nbsp;Christopher W. Teshima,&nbsp;Gary R. May,&nbsp;Natalia Causada Calo","doi":"10.1002/deo2.70078","DOIUrl":"https://doi.org/10.1002/deo2.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction and objectives</h3>\u0000 \u0000 <p>Endoscopic ampullectomy is the preferred treatment for selected periampullary lesions, yet up to 10.6% of patients may experience delayed bleeding post-procedure. This study aims to identify predictors for bleeding, which remain poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a single-center retrospective cohort study of adult patients who underwent endoscopic ampullectomy (EA) between January 2011 and September 2023. The primary outcome was the risk factors for delayed bleeding, defined as post-procedural bleeding that necessitated either an emergency department visit, hospital admission, blood transfusion, or re-intervention. Secondary outcomes included adverse events, such as perforation and pancreatitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 113 patients underwent EA, and 25 (22.1%) experienced delayed bleeding. Of these, 20 (80%) required repeat endoscopy, six (24%) needed blood transfusions, and three (12%) were managed conservatively. Multivariable logistic regression analysis identified international normalized ratio ≥1.2 (odds ratio [OR] 3.32, 95% confidence interval [95% CI] 1.03–10.74, <i>p</i> = 0.05), presence of high-grade dysplasia or intramucosal cancer (OR 3.76, 95% CI 1.20–11.81, <i>p</i> = 0.03), female sex (OR 3.14, 95% CI 1.11–8.93, <i>p</i> = 0.03), size of lesion (OR 1.04, 95% CI 1.01–1.08, <i>p</i> = 0.03) and procedure duration (OR 0.98, 95% CI 0.97–0.99, <i>p</i> = 0.04) as independent predictors of delayed bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Several factors, including features of high-grade dysplasia-intramucosal cancer, international normalized ratio ≥1.2, female sex, lesion size, and procedure duration are associated with delayed post-ampullectomy bleeding. These factors should be taken into consideration when strategizing the reduction of post-ampullectomy bleeding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423711","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":"Feasibility of endoscopic ultrasound-guided hepaticogastrostomy using a novel long balloon catheter","authors":"Yuichi Takano,&nbsp;Naoki Tamai,&nbsp;Masataka Yamawaki,&nbsp;Jun Noda,&nbsp;Tetsushi Azami,&nbsp;Fumitaka Niiya,&nbsp;Naotaka Maruoka,&nbsp;Tatsuya Yamagami,&nbsp;Masatsugu Nagahama","doi":"10.1002/deo2.70082","DOIUrl":"https://doi.org/10.1002/deo2.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Recently, a novel long balloon catheter for tract dilation in endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) was developed. The balloon measures 6 cm in length, which enables one-step tract dilation of the gastric wall, liver parenchyma, and bile duct wall, contributing to shorter procedure times and reduced bile leakage. This study investigated the feasibility of EUS-HGS with this new balloon catheter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included consecutive cases in which EUS-HGS was performed using a novel long balloon catheter (3 mm in diameter) for malignant distal biliary obstructions between February 2024 and October 2024. The patients' clinical background and procedural details were retrospectively examined using medical records. The primary outcome was technical success, defined as successful stent placement without additional dilation using devices other than the new balloon catheter. The secondary outcomes were clinical success and adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 10 patients. The median age was 82.5 years, and there were seven males and three females. The median procedure time was 20 min. Technical success was achieved in 90% and clinical success was achieved in 100%. Regarding adverse events, one patient developed moderate cholecystitis, and percutaneous transhepatic gallbladder drainage was performed. No bile leakage, peritonitis, bleeding, or perforation was observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The new long balloon catheter is an excellent device that can reliably dilate the whole tract with a single inflation. EUS-HGS using a novel long balloon catheter is a feasible treatment option.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423712","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 case of intramural esophageal dissection caused by vomiting during barium esophagography","authors":"Takuya Ogiso,&nbsp;Shuji Ikegami,&nbsp;Tomohiko Matsuba,&nbsp;Yusuke Takeuchi,&nbsp;Masahiro Takayanagi","doi":"10.1002/deo2.70081","DOIUrl":"https://doi.org/10.1002/deo2.70081","url":null,"abstract":"<p>Intramural esophageal dissection is a rare disease characterized by a laceration of the submucosal layer in the esophageal wall due to mechanical damage or esophageal pressure, resulting in the separation of the mucosal layer from the muscularis layer. This report presents a case of intramural esophageal dissection induced by vomiting during barium esophagography in a 70-year-old man undergoing evaluation for esophageal cancer. Preoperative assessments included endoscopic biopsies and the placement of a marking clip, followed by barium esophagography. During the procedure, the patient experienced vomiting and subsequent neck-chest pain. Computed tomography revealed a barium-filled dissection cavity within the esophagus. Esophagogastroduodenoscopy identified submucosal dissection proximal to esophageal cancer, exposing the muscularis layer and the entry site was at the same level as the biopsy site. The patient was treated conservatively with fasting, leading to symptom resolution. Follow-up endoscopic evaluations confirmed that the entry site remained open but epithelialized, and the esophageal wound had healed.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423713","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":"Feasibility of a novel self-assembling submucosal injection peptide solution for endoscopic mucosal resection of colorectal lesions: A multicenter study","authors":"Keigo Sato,&nbsp;Takehide Fukuchi,&nbsp;Shinpei Kondo,&nbsp;Yuya Nakano,&nbsp;Yoko Hachisu,&nbsp;Kengo Kasuga,&nbsp;Ayako Matsui,&nbsp;Hironori Aoki,&nbsp;Kohei Takizawa,&nbsp;Shiko Kuribayashi,&nbsp;Yoji Takeuchi,&nbsp;Toshio Uraoka","doi":"10.1002/deo2.70069","DOIUrl":"https://doi.org/10.1002/deo2.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Although a novel submucosal injection material consisting of a fully synthetic, self-assembling peptide solution, PuraLift, has recently become commercially available in Japan, there are a few reports regarding the usefulness of this solution. The aim of this study was to investigate the feasibility of PuraLift for conventional endoscopic mucosal resection (EMR) in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter retrospective study was conducted at the endoscopy units of five institutions from January 2023 to May 2023. Consecutive patients who underwent EMR with PuraLift for 5–20-mm colorectal lesions were included in the introduction of this solution at each institute. The primary endpoint was the “effective resection” rate, defined as pathological complete resection, with “effective injection” defined as requiring no more than one additional injection due to adequate maintenance of mucosal lifting during EMR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 110 lesions in 70 patients were treated by conventional EMR using PuraLift. En-bloc resection was performed for 109 (99%) lesions, and complete resection was performed for 102 (93%) lesions. More than 95% of the lesions were neoplastic. Additional injections were required in only two lesions. Both were single additional injections, and the median overall injection volume was 1.5 mL. Therefore, the effective injection rate was 93% (95% confidence interval, 86%–96%). No adverse events occurred during the study period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although direct comparison with other materials is required, PuraLift seems feasible as an injection material for EMR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397129","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":"Influence of antiplatelet drugs on gastric ulcer healing after endoscopic submucosal dissection in patients with early gastric cancer","authors":"Kazuto Takahashi,&nbsp;Takuto Nosaka,&nbsp;Yosuke Murata,&nbsp;Ryotaro Sugata,&nbsp;Yu Akazawa,&nbsp;Tomoko Tanaka,&nbsp;Tatsushi Naito,&nbsp;Hidetaka Matsuda,&nbsp;Masahiro Ohani,&nbsp;Hiroyuki Suto,&nbsp;Yasunari Nakamoto","doi":"10.1002/deo2.70070","DOIUrl":"https://doi.org/10.1002/deo2.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The causes of drug-induced gastroduodenal injuries primarily include antithrombotic drugs, including low-dose aspirin, non-steroidal anti-inflammatory drugs, and corticosteroids. These drugs are suspected to affect gastric ulcer healing after endoscopic submucosal dissection (ESD). This study aimed to investigate the effects of these drugs on post-ESD ulcer healing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 170 lesions (149 patients) who had undergone ESD for early gastric cancer. Post-ESD ulcers were endoscopically measured on the 1st, 28th, and 56th days after ESD and were analyzed to identify potential risk factors for delayed ulcer healing among patients taking antiplatelet drugs, anticoagulant drugs, non-steroidal anti-inflammatory drugs, corticosteroids, and no drugs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Multivariate analysis for the frequency of scarring on the 56^th day after ESD showed that antiplatelet drugs (odds ratio [OR], 3.905; <i>p</i> = 0.017), ulcer size of ≥40 mm on the first day (OR, 4.903; <i>p</i> = 0.006), hemoglobin A1c ≥6.5% (OR 7.659, <i>p</i> = 0.012), and age of ≥75 (OR, 5.227; <i>p</i> = 0.007) were independent risk factors of delayed ulcer healing. Anticoagulant drugs, non-steroidal anti-inflammatory drugs, and corticosteroids were not significant factors. Among antiplatelet drugs, the ulcer reduction ratio for clopidogrel on the 28th day after ESD was 84.8%, which was significantly lower than the ulcer reduction ratio of 92.8% for no drug (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>As antiplatelet drugs, particularly clopidogrel, may delay gastric ulcer healing after ESD, careful endoscopic follow-up and drug therapy are suggested for patients taking these drugs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380619","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":"What is behind the chest pain? Rare esophageal hematoma caused by betel nut: A case report","authors":"Chundi Guan,&nbsp;Meng Yang Wang,&nbsp;Xingfang Jia","doi":"10.1002/deo2.70074","DOIUrl":"https://doi.org/10.1002/deo2.70074","url":null,"abstract":"<p>This case report reported a case of huge esophageal hematoma caused by chewing betel nut. The patient was admitted to the hospital due to chest pain. After a multidisciplinary diagnosis by the Department of Gastroenterology, Cardiology, and Radiology, it was finally determined that the patient's chest pain was caused by a huge esophageal hematoma. After diagnosis and treatment, we observed the longitudinal ulcer after the healing of the esophageal giant hematoma. This case report provides evidence that chewing betel nuts may be a cause of gastrointestinal bleeding.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380023","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}