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Practical approach to linear endoscopic ultrasound examination of the gallbladder

World Journal of Radiology 2024年第6期16卷 184-195页

作者： Hussein Hassan Okasha Eyad Gadour Hassan Atalla Omar AbdAllah AbdEl-Hameed Reem Ezzat ahmed Elsayed alzamzamy Elsayed Ghoneem Rasha Ahmad Matar Zeinab Hassan Bogdan Miutescu Ayman Qawasmi Katarzyna M Pawlak ahmed Elmeligui Department of Internal Medicine Division of Gastroenterology and HepatologyKasr Al-Aini School of MedicineCairo UniversityCairo 11562Egypt Department of Gastroenterology and Hepatology King Abdulaziz Hospital-National GuardAhsa 31982Saudi Arabia Department of Medicine School of MedicineZamzam University CollegeKhartoum 11113Sudan Department of Internal Medicine Hepatology and Gastroenterology UnitFaculty of MedicineMansoura UniversityMansoura 35516Egypt Department of Internal Medicine Faculty of MedicineAssiut UniversityAssiut 71511Egypt Department of Gastroenterology and Heptology Maadi Armed Forces Medical ComplexMilitary Medical AcademyCairo 11728Egypt Department of Gastroenterology and Advance Endoscopy Sultant Qaboos Comprehensive Cancer Care and Research CentreMuscat 0961Oman Department of Internal Medicine Stockport Hospitals NHS Foundation TrustManchester SK27JEUnited Kingdom Department of Gastroenterology and Hepatology Victor Babes University of Medicine and PharmacyTimisoara 300041Romania Advanced Regional Research Centre in Gastroenterology and Hepatology Victor Babes University of Medicine and PharmacyTimisoara 30041Romania Department of Gastroenterology Al-Makassed Islamic Charitable Society HospitalCairo 11124Egypt Division of Gastroenterology St.Michael’s HospitalUniversity of TorontoToronto M5B 1W8Canada Department of Gastroenterology Southend University HospitalEssex SS26XTUnited Kingdom

The gallbladder(GB)is a susceptible organ,prone to various pathologies that can be identified using different imaging *** ultrasound(TUS)is typically the initial diagnostic method due to its numerous well-established ***,in cases of uncertainty or when a definitive diagnosis cannot be established,computed tomography(CT)or magnetic resonance imaging may be employed to provide more detailed ***,CT scans may sometimes offer inadequate spatial resolution,which can limit the differentiation of GB lesions,particularly when smaller yet clinically relevant abnormalities are ***,endoscopic ultrasound(EUS)provides higher frequency compared to TUS,superior spatial resolution,and the option for contrast-enhanced harmonic imaging,enabling a more comprehensive ***,EUS can serve as a supplementary tool when conventional imaging methods are *** review will describe the standard EUS examination of the GB,focusing on its endosonographic characteristics in various GB path-ologies.

关键词： Endoscopic ultrasound Linear endoscopic ultrasound Gallbladder anatomy Gallbladder pathologies Therapeutic endoscopic ultrasound

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Serum vascular endothelial growth factor as a tumor marker for hepatocellular carcinoma in hepatitis C virus-related cirrhotic patients

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World Journal of Gastrointestinal Oncology 2021年第6期13卷 600-611页

作者： ahmed alzamzamy Huda Elsayed Mona Abd Elraouf Hanan Eltoukhy Tarek Megahed Ashraf Aboubakr Department of Gastroenterology and Hepatology Military Medical AcademyCairo 11841Egypt Department of Gastroenterology and Hepatology Maadi Armed Forces Medical ComplexCairo 11841Egypt Department of Internal Medicine Faculty of Medicine for GirlsAl-Azhar UniversityCairo 11311Egypt Department of Clinical Pathology Military Medical AcademyCairo 11311Egypt

BACKGROUND Hepatocellular carcinoma(HCC)accounts for 8.2%of all cancer-related deaths *** a vascular tumor,vascular endothelial growth factor(VEGF)plays a vital role in HCC pathogenesis,growth,and *** To determine the accuracy of serum VEGF and VEGF/platelet(PLT)as tumor markers in the early detection of HCC cases in patients with hepatitis C virus(HCV)-related liver *** We conducted a case-control study with HCV patients from the outpatient and inpatient hepatology *** were classified into three groups:(1)HCC group;(2)Cirrhosis group;and(3)HCV without cirrhosis(control group).Patients were clinically evaluated,and blood samples were drawn for the analysis;serum VEGF levels were measured by a specific VEGF human recombinant enzyme-linked immunosorbent assay *** from the three study groups were compared by the one-way analysis of variance or Kruskal-Wallis *** operating characteristic curves were constructed to determine the optimal cut-off values of alpha fetoprotein(AFP),VEGF,and VEGF/PLT that provided the best diagnostic *** sensitivity and specificity at the optimal cut-off value of each biomarker were then *** This study included one hundred patients(HCC,cirrhosis,and control groups:n=40,30,30,respectively).HCC patients had significantly higher serum VEGF and VEGF/PLT levels than the non-HCC groups(P=0.001).Serum VEGF and VEGF/PLT showed significant positive correlations with and HCC tumor size,stage,vascular invasion,and Child-Pugh ***,a VEGF cut-off the value of 250 pg/mL provided 80%sensitivity and 81.7%specificity for discriminating HCC patient from non-HCC ***,the ratio of VEGF/PLT provided sensitivity and specificity of 77.5%and 80%,respectively which is higher than the accuracy provided by *** combination of AFP,VEGF,and VEGF/PLT increases the accuracy of diagnosing HCC to>95%.CONCLUSION In HCV patients,serum VEGF and VEGF/PLT separ

关键词： Hepatocellular carcinoma Vascular endothelial growth factor Biomarkers Diagnosis

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Cystic pancreatic lesions,the endless dilemma

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World Journal of Gastroenterology 2021年第21期27卷 2664-2680页

作者： Hussein Hassan Okasha Abeer Awad ahmed El-meligui Reem Ezzat Ashraf Aboubakr Sameh AbouElenin Ramy El-Husseiny ahmed alzamzamy Department of Internal Medicine and Gastroenterology Hepatology UnitKasr Al-Aini HospitalsCairo UniversityCairo 11562Egypt Department of Internal Medicine and Gastroenterology Hepatology UnitAssuit UniversityAssuit 71515Egypt Department of Gastroenterology and Hepatology Maadi Armed Forces Medical ComplexMilitary Medical AcademyCairo 11441Egypt Department of Gastroenterology and Hepatology Military Medical AcademyCairo 11441Egypt Department of Hepatology and Tropical Medicine National Hepatology and Tropical Medicine Research Institute(NHTMRI)Cairo 11441Egypt

Cystic pancreatic lesions involve a wide variety of pathological entities that include neoplastic and non-neoplastic *** proper diagnosis,differentiation,and staging of these cystic lesions are considered a crucial issue in planning further *** are great challenges for their diagnostic *** our time,new emerging methods for this diagnosis have been *** ultrasonography-guided fine-needle aspiration cytology with chemical and molecular analysis of cyst fluid and EUS-guided fine needlebased confocal laser endomicroscopy,through the needle microforceps biopsy,and single-operator cho-langioscopy/pancreatoscopy are promising methods that have been used in the diagnosis of cystic pancreatic *** we discuss the diagnosis of cystic pancreatic lesions and the benefits of various diagnostic models.

关键词： Pancreatic cystic lesion Endoscopic diagnosis Endoscopic ultrasonography Cyst fluid markers Endoscopic ultrasonography-guided fine needle-based confocal laser endomicroscopy Through the needle microforceps biopsy Single operator cholangioscopy/pancreatoscopy

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Endoscopic resection of superficial bowel neoplasia:The unmet needs in the Egyptian practice

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World Journal of Gastrointestinal Endoscopy 2022年第4期14卷 235-249页

作者： Mohamed H Emara Mariam Zaghloul Haidi Karam-Allah Ramadan Salem Youssef Mohamed Mohammed Tag-Adeen ahmed alzamzamy Mohamed Alboraie Ahmad Madkour ahmed Youssef Altonbary Tarik I Zaher ahmed Abo Elhassan Nermeen Abdeen Mohammed Hussien ahmed Department of Hepatology Gastroenterology and Infectious DiseasesKafrelsheikh UniversityKafr Elshiekh 33516Egypt Department of Tropical Medicine and Gastroenterology Assiut UniversityAssiut 71515Egypt Department of Internal Medicine Faculty of MedicineGastroenterology and Hepatology UnitZagazig UniversityZagazig 44519Egypt Division of Gastroenterology and Hepatology Department of Internal MedicineSouth Valley UniversityQena Faculty of MedicineQena 83523Egypt Department of Gastroenterology and Hepatology Maadi Armed Forces Medical ComplexMilitary Medical AcademyCairo 11841Egypt Department of Internal Medicine Al-Azhar UniversityCairo11884Egypt Department of Endemic Medicine Helwan UniversityCairo 11795Egypt Department of Gastroenterology and Hepatology Mansoura UniversityMansoura 35516Egypt Department of Tropical Medicine Zagazig UniversityZagazig 44519Egypt Department of Tropical Medicine Suez Canal UniversityIsmailia 41522Egypt Department of Tropical Medicine Alexandria UniversityAlexandria 21526Egypt

BACKGROUND Management of superficial bowel neoplasia(SBN)in early stages is associated with better *** last few decades experienced a paradigm shift in the management of SBN with the introduction of advanced endoscopic resection techniques(ERTs).However,there are no clear data about the aspects of ERTs in Egypt despite the growing gastroenterology *** To investigate the knowledge,attitude,and practice of ERTs toward management of SBN among Egyptian practitioners and the suitability of the endoscopy units’infrastructures toward these *** An online 2-pages questionnaire was *** first page comprised demographic data,and questions for all physicians,about the knowledge(11 questions)of and attitude(5 questions)toward ERTs as a therapeutic option for *** second page investigated the practice of ERTs by endoscopists(6 questions)and the infrastructures of their endoscopy units(14 questions).The survey was disseminated through July 2021 and the data were collected in an excel sheet and later analyzed *** The complete responses were 833/2300(36.2%).The majority of the participants were males(n=560,67.2%),middle-aged(n=366,43.9%),consultants(n=464,55.7%),gastroenterologists(n=678,81.4%),spending≥15 years in practice(n=368,44.2%),and were working in university hospitals(n=569,68.3%).The majority correctly identified the definition of SBN(88.4%)and the terms polypectomy,endoscopic mucosal resection(EMR),and endoscopic submucosal dissection(ESD)(92.1%,90.2%,and 89.1%respectively).However,26.9%,43.2%and 49.5%did not recognize the clear indication of polypectomy,EMR,and ESD *** 68.1%of physicians are convinced about the ERTs for management of SBN;only 8.9%referred all candidate cases for *** 76.5%of endoscopists had formal training in the basic polypectomy techniques while formal training for EMR and ESD was encountered only in 31.9%and 7.2%*** 71.6%and 88.4%of endoscopists did not per

关键词： Endoscopic submucosal dissection Endoscopic mucosal resection Polypectomy Superficial bowel neoplasia Egypt

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Cronkhite-Canada syndrome:First case report from Egypt and North Africa

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World Journal of Gastrointestinal Endoscopy 2022年第10期14卷 642-647页

作者： ahmed Elsayed alzamzamy Ashraf Aboubakr Hussein H Okasha Abeer Abdellatef Shaimaa Elkholy Mahmoudd Wahba Mohamed Alboraie Hussein Elsayed Mohamed O Othman Department of Gastroenterology and Hepatology Maadi Armed Forces Medical ComplexMilitary Medical AcademyCairo 11711Egypt Department of Internal Medicine Division of GastroenterologyHepatology and EndoscopyCairo UniversityCairo 11311Egypt Department of Internal Medicine Al-Azhar UniversityCairo 11311Egypt Department of Pathology Military Medical AcademyCairo 11711Egypt Department of Internal Medicine Baylor College of MedicineHoustonTX 77082United States

BACKGROUND Gastrointestinal(GI)polyposis is a rare condition in GI *** date about 500 cases of Cronkhite-Canada syndrome(CCS)have been reported *** SUMMARY We report a 60-year-old female patient who presented with dyspepsia,abdominal pain,and weight loss of 1-year *** physical examination showed alopecia and *** endoscopy revealed diffuse markedly thickened gastric mucosa involving the whole stomach with thickened gastric rugae and numerous polypoidal *** examination showed marked hyperplasia of the foveolar glands with inflammatory cell *** ultrasound showed a significantly hypertrophic mucosa and muscularis mucosa,while the submucosa and the muscularis propria were spared,favouring its benign *** showed multiple sessile polyps scattered at different parts of the *** examination revealed tubular adenomatous polyps with low-grade *** diagnoses included CCS,Menterier disease(MD),other polyposis syndromes,lymphoma,amyloidosis,and gastric *** presence of alopecia,nail dystrophy,GI polyposis,markedly thickened gastric mucosa and folds,abdominal pain,weight loss,and marked foveolar gland hyperplasia;all was in favour of *** was excluded due to sparing of the muscularis *** presence of colonic polyps and antral and duodenal infiltration,and the absence of hypoproteinaemia decreased the possibility for *** The patient was diagnosed as having CCS.

关键词： Gastrointestinal polyposis Thickened gastric mucosa Cronkhite-Canada syndrome Case report

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Barriers for resuming endoscopy service in the context of COVID-19 pandemic:A multicenter survey from Egypt

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World Journal of Gastroenterology 2020年第43期26卷 6880-6890页

作者： Omar Elshaarawy Sameh Aldesoky Lashen Nahed A Makhlouf Doaa Abdeltawab Mariam Salah Zaghloul Rasha M ahmed Hayam Fathy Shimaa Afifi Muhammad Abdel-Gawad Eman Abdelsameea Sherief Abd-Elsalam Salem Youssef Mohamed Mohammed Tag-Adeen Mina Tharwat ahmed alzamzamy ahmed Nasr Bekhit Alshaimaa M Eid Abeer Awad Mohamed-Naguib Wifi Mohammad Aamr Waleed A Abd El Dayem Mohamed Alboraie Department of Hepatology Gastroenterology and Liver TransplantationNational Liver InstituteMenoufia UniversityShebine Elkom 32511Egypt Department of Internal Medicine and Center of Alcohol Research and Liver Diseases Salem Medical CenterHeidelberg UniversityHeidelberg 69121Germany Department of Internal Medicine Faculty of MedicineUniversity of AlexandriaAlexandria 21521Egypt Department of Tropical Medicine and Gastroenterology Faculty of MedicineAssiut UniversityAssiut 71515Egypt Department of Hepatology Gastroentrology and Infectious DiseasesKafrelsheikh UniversityFaculty of MedicineKafrelsheikh 33565Egypt Department of Internal Medicine Faculty of MedicineAssiut UniversityAssiut 71515Egypt National Hepatology and Tropical Medicine Research Institute Cairo 11638Egypt Department of Hepatology Gastroenterology and Infectious DiseasesFaculty of MedicineAl-Azhar UniversityAssiut 71524Egypt Department of Tropical Medicine and Infectious Diseases Faculty of MedicineTanta UniversityTanta 31527Egypt Department of Internal Medicine Gastroenterology and Hepatology UnitFaculty of MedicineZagazig UniversityZagazig 44519Egypt Department of Internal Medicine Gastroenterology UnitQena Faculty of MedicineSouth Valley UniversityQena 83523Egypt Department of Tropical Medicine and Gastroenterology Faculty of MedicineAswan UniversityAswan 81528Egypt Department of Gastroenterology and Hepatology Military Medical AcademyCairo 11771Egypt Department of Tropical Medicine Zagazig General HospitalZagazig 42511Egypt Department of Hepatology and Gastroenterology and Infectious Disease Faculty of MedicineAlAzhar UniversityCairo 11562Egypt Department of Internal Medicine Faculty of MedicineCairo UniversityCairo 11759Egypt Department of Hepatology and Gastroentorolgy Shebin Elkom Teaching HospitalShebine Elkom 3521Egypt Department of Tropical Medicine Faculty of MedicineZagazig UniversityZagazig 44519Egypt Department of Internal Medicine Al-Azhar UniversityCairo 11651Egypt

BACKGROUND The current coronavirus disease 2019(COVID-19)pandemic has affected routine endoscopy service across the gastroenterology *** led to the suspension of service provision for elective *** To assess the potential barriers for resuming the endoscopy service in *** A national online survey,four domains,was disseminated over a period of 4 wk in August *** primary outcome of the survey was to determine the impact of the COVID-19 pandemic on the endoscopy service and barriers to the full resumption of a disabled center(s).RESULTS A hundred and thirteen Egyptian endoscopy centers participated in the *** waiting list was increased by≥50% in 44.9% of areas with clusters of COVID-19 cases(n=49)and in 35.5% of areas with sporadic cases(n=62).Thirty nine(34.8%)centers suffered from staff shortage,which was considered a barrier against service resumption by 86.4% of centers in per-protocol *** multivariate analysis,the burden of cases in the unit locality,staff shortage/recovery and the availability of separate designated rooms for COVID-19 cases could markedly affect the resumption of endoscopy practice(P=0.029,<0.001 and 0.02,respectively)and Odd’s ratio(0.15,1.8 and 0.16,respectively).CONCLUSION The COVID-19 pandemic has led to restrictions in endoscopic *** staff shortage/recovery and the availability of COVID-19 designed rooms are the most important barriers against *** working hours and dividing endoscopy staff into teams may help to overcome the current situation.

关键词： COVID-19 Endoscopy Practice Pandemic Egypt Barriers

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