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Will artificial intelligence reach any limit in gastroenterology?

Artificial Intelligence in Gastroenterology 2024年第2期5卷 1-9页

作者： Joseph Bou Jaoude Rose Al Bacha bassam abboud Department of Gastroenterology Levant HospitalBeirut 166830Lebanon Department of General Surgery Geitaoui HospitalFaculty of MedicineLebanese UniversityLebanonBeirut 166830Lebanon

Endoscopy is the cornerstone in the management of digestive *** the last few decades,technology has played an important role in the development of this field,helping endoscopists in better detecting and characterizing luminal ***,despite ongoing advancements in endoscopic technology,the incidence of missed pre-neoplastic and neoplastic lesions remains high due to the operator-dependent nature of endoscopy and the challenging learning curve associated with new *** intelligence(AI),an operator-independent field,could be an invaluable *** can serve as a“second observer”,enhancing the performance of endoscopists in detecting and characterizing luminal *** utilizing deep learning(DL),an innovation within machine learning,AI automatically extracts input features from targeted endoscopic *** encompasses both computer-aided detection and computer-aided diagnosis,assisting endoscopists in reducing missed detection rates and predicting the histology of luminal digestive *** applications in clinical gastrointestinal diseases are continuously expanding and evolving the entire digestive *** all published studies,real-time AI assists endoscopists in improving the performance of non-expert gastroenterologists,bringing it to a level comparable to that of *** development of DL may be affected by selection *** have utilized different AI-assisted models,which are *** the future,algorithms need validation through large,randomized ***,AI has no limit to assist endoscopists in increasing the accuracy and the quality of endoscopic ***,practically,we still have a long way to go before standardizing our AI models to be accepted and applied by all gastroenterologists.

关键词： Artificial intelligence Digestive tract Gastroenterology Gastroscopy Coloscopy

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Occult sporadic insulinoma: Localization and surgical strategy

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World Journal of Gastroenterology 2008年第5期14卷 657-665页

作者： bassam abboud Joe Boujaoude Department of General Surgery Hotel Dieu de France Hospital Faculty of Medicine Saint-Joseph University Beirut 166830 Lebanon Department of Gastroenterology Hotel Dieu de France Hospital Faculty of Medicine Saint-Joseph University Beirut 166830 Lebanon

Insulinomas continue to pose a diagnostic challenge to physicians, surgeons and radiologists alike. Most are intrapancreatic, benign and solitary. Biochemical diagnosis is obtained and imaging techniques to localize lesions continue to evolve. Surgical resection is the treatment of choice. Despite all efforts, an occult insulinoma (occult insulinoma refers to a biochemically proven tumor with indeterminate anatomical site before operation) may still be encountered. New localization preoperative techniques decreases occult cases and the knowledge of the site of the mass before surgery allows to determine whether enucleation of the tumor or pancreatic resection is likely to be required and whether the tumor is amenable to removal via a laparoscopic approach. In absence of preoperative localization and intraoperative detection of an insulinoma, blind pancreatic resection is not recommended.

关键词： Insulinoma Occult CT scan Endoscopic ultrasonography Surgery Laparoscopy

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Digestive manifestations of parathyroid disorders

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World Journal of Gastroenterology 2011年第36期17卷 4063-4066页

作者： bassam abboud Ronald Daher Joe Boujaoude Department of General Surgery Hotel Dieu de France HospitalFaculty of MedicineSaintJoseph UniversityBeirut 166830Lebanon Department of Gastroenterology Hotel Dieu de France HospitalFaculty of MedicineSaint-Joseph UniversityBeirut 166830Lebanon

The parathyroid glands are the main regulator of plasma calcium and have a direct influence on the digestive *** disturbances often result in unknown long-standing *** main manifestation of hypoparathyroidism is steatorrhea due to a deficit in exocrine pancreas *** association with celiac sprue may contribute to *** causes smooth-muscle atony,with upper and lower gastrointestinal symptoms such as nausea,heartburn and *** and peptic ulcer were strongly linked before the advent of proton pump ***,this association remains likely only in the particular context of multiple endocrine neoplasia type 1/Zollinger-Ellison *** contrast to chronic pancreatitis,acute pancreatitis due to primary hyperparathyroidism is one of the most studied *** causative effect of high calcium level is confirmed and the distinction from secondary hyperparathyroidism is *** digestive manifestations of parathyroid malfunction are often overlooked and serum calcium level must be included in the routine workup for abdominal symptoms.

关键词： Dysparathyroidism Hypoparathyroidism Hyperparathyroidism Digestive manifestations Steatorrhea Pancreatitis Pepticulcer

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Acute mesenteric ischemia after cardio-pulmonary bypass surgery

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World Journal of Gastroenterology 2008年第35期14卷 5361-5370页

作者： bassam abboud Ronald Daher Joe Boujaoude Department of General Surgery Hotel Dieu de France HospitalFaculty of MedicineSaint-Joseph UniversityBeirut 16-6830Lebanon Department of Gastroenterology Hotel Dieu de France HospitalFaculty of MedicineSaint-Joseph UniversityBeirut 16-6830Lebanon

Acute mesenteric ischemia (AMI) is a highly-lethal surgical emergency. Several pathophysiologic events (arterial obstruction, venous thrombosis and diffuse vasospasm) lead to a sudden decrease in mesenteric blood flow. Ischemia/reperfusion syndrome of the intestine is responsible for systemic abnormalities, leading to multi-organ failure and death. Early diagnosis is difficult because the clinical presentation is subtle, and the biological and radiological diagnostic tools lack sensitivity and specificity. Therapeutic options vary from conservative resuscitation, medical treatment, endovascular techniques and surgical resection and revascularization. A high index of suspicion is required for diagnosis, and prompt treatment is the only hope of reducing the mortality rate. Studies are in progress to provide more accurate diagnostic tools for early diagnosis. AMI can complicate the post-operative course of patients following cardio-pulmonary bypass (CPB). Several factors contribute to the systemic hypo-perfusion state, which is the most frequent pathophysiologic event. In this particular setting, the clinical presentation of AMI can be misleading, while the laboratory and radiological diagnostic tests often produce inconclusive results. The management strategies are controversial, but early treatment is critical for saving lives. Based on the experience of our team, we consider prompt exploratory laparotomy, irrespective of the results of the diagnostic tests, isthe only way to provide objective assessment and adequate treatment, leading to dramatic reduction in the mortality rate.

关键词： Acute mesenteric ischemia Non-occlusive Cardio-pulmonary bypass Laparotomy Prognosis Mortality

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Idiopathic sclerosing encapsulating peritonitis:Abdominal cocoon

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World Journal of Gastroenterology 2012年第17期18卷 1999-2004页

作者： Jenny N Tannoury bassam N abboud Department of General Surgery Faculty of MedicineHotel Dieu de France HospitalSaint-Joseph UniversityBeirut 16-6830Lebanon

Abdominal cocoon,the idiopathic form of sclerosing encapsulating peritonitis,is a rare condition of unknown etiology that results in an intestinal obstruction due to total or partial encapsulation of the small bowel by a f ibrocollagenous *** diagnosis requires a high index of clinical *** early clinical features are nonspecif ic,are often not recognized and it is diff icult to make a def inite pre-operative *** suspicion may be generated by the recurrent episodes of small intestinal obstruction combined with relevant imaging f indings and lack of other plausible *** radiological diagnosis of abdominal cocoon may now be conf idently made on computed tomography *** is important in the management of this *** dissection and excision of the thick sac with the release of the small intestine leads to complete recovery in the vast majority of cases.

关键词： Peritonitis Sclerosis Encapsulate Intestinal obstruction Computed tomography scan Surgery

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Hepatic portal venous gas: Physiopathology, etiology, prognosis and treatment

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World Journal of Gastroenterology 2009年第29期15卷 3585-3590页

作者： bassam abboud Jad El Hachem Thierry Yazbeck Corinne Doumit Department of General Surgery Hotel-Dieu de France Hospital Boulevard Alfred Naccache Beirut 16-6830 Lebanon

Hepatic portal venous gas (HPVG), an ominous radiologic sign, is associated in some cases with a severe underlying abdominal disease requiring urgent operative intervention. HPVG has been reported with increasing frequency in medical literature and usually accompanies severe or lethal conditions. The diagnosis of HPVG is usually made by plain abdominal radiography, sonography, color Doppler flow imaging or computed tomography (CT) scan. Currently, the increased use of CT scan and ultrasound in the inpatient setting allows early and highly sensitive detection of such severe illnesses and also the recognition of an increasing number of benign and non-life threatening causes of HPVG. HPVG is not by itself a surgical indication and the treatment depends mainly on the underlying disease. The prognosis is related to the pathology itself and is not influenced by the presence of HPVG. Based on a review of the literature, we discuss in this paper the pathophysiology, risk factors, radiographic findings, management, and prognosis of pathologies associated with HPVG.

关键词： Hepatic portal venous gas Bowel ischemia/necrosis Diverticulitis Gastric pathologies Ulcerativecolitis Abdominal computed tomography scan Crohn'sdisease Liver transplantation Chemotherapy

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Consequences of dysthyroidism on the digestive tract and viscera

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World Journal of Gastroenterology 2009年第23期15卷 2834-2838页

作者： Ronald Daher Thierry Yazbeck Joe Bou Jaoude bassam abboud Department of General Surgery Hotel Dieu de France Hospital Faculty of Medicine Saint-Joseph University Beirut 16-6830 Lebanon Department of Gastroenterology Hotel Dieu de France Hospital Faculty of Medicine Saint-Joseph University Beirut 16-6830 Lebanon

Thyroid hormones def ine basal metabolism throughout the body, particularly in the intestine and viscera. Gastrointestinal manifestations of dysthyroidism are numerous and involve all portions of the tract. Thyroid hormone action on motility has been widely studied, but more complex pathophysiologic mechanisms have been indicated by some studies although these are not fully understood. Both thyroid hormone excess and def iciency can have similar digestive manifestations, such as diarrhea, although the mechanism is different in each situation. The liver is the most affected organ in both hypo-and hyperthyroidism. Specifi c digestive diseases may be associated with autoimmune thyroid processes, such as Hashimoto's thyroiditis and Grave's disease. Among them, celiac sprue and primary biliary cirrhosis are the most frequent although a clear common mechanism has never been proven. Overall, thyroid-related digestive manifestations were described decades ago but studies are still needed in order to conf irm old concepts or elucidate undiscovered mechanisms. All practitioners must be aware of digestive symptoms due to dysthyroidism in order to avoid misdiagnosis of rare but potentially lethal situations.

关键词： Hypothyroidism Hyperthyroidism Gastroin-testinal motility Intestine Liver Viscera

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An exceptional cause of left lower quadrant abdominal pain

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World Journal of Gastroenterology 2009年第27期15卷 3451-3451页

作者： bassam abboud Ronald Daher Department of General Surgery Hotel-Dieu de France HospitalBoulevard Alfred Naccache Beirut 16-6830 Lebanon

Acute appendidtis is an exceptional cause of left lower quadrant abdominal pain. Computed tomography scan is the key to its diagnosis and helps to establish its early treatment. We present a case of a 35-year-old male patient who presented acute appendicitis with redundant and loosely attached cecum which was diagnosed based on his left lower quadrant abdominal pain.

关键词： Abdominal pain Left lower quadrant Appendicitis Cecum Computed tomography scan Surgery

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Vanek's tumor of the small bowel in adults

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World Journal of Gastroenterology 2015年第16期21卷 4802-4808页

作者： bassam abboud Department of General Surgery Hotel Dieu de France HospitalFaculty of MedicineSaint-Joseph University

Inflammatory fibroid polyps(IFPs), or Vanek's tumor, are one of the least common benign small bowel *** affects both sexes and all age groups, with a peak of incidence in the fifth and seventh *** can be found throughout the gastrointestinal tract but most commonly in the gastric antrum or *** underlying cause of IFPs is still *** study of IFP showed mutations in platelet derived growth factor alpha in some *** the time of diagnosis most IFPs have a diameter of 3 to 4 *** lesions have always been recorded as solitary *** depend on the location and the size of the lesion, including abdominal pain, vomiting, altered small bowel movements, gastrointestinal bleeding and loss of *** arising below the Treitz ligament can present with an acute abdomen, usually due to *** computed tomography is currently considered the most sensitive radiological method to show the polyp or to confirm *** inflammatory fibroid polyps can be removed by *** is rarely *** laparoscopy or laparotomy is frequently recommended as the best treatment for intussusceptions caused by *** operation should be performed as early as possible in order to prevent the intussusceptions from leading to ischemia, necrosis and subsequent perforation of the invaginated bowel *** report aims at reviewing the diagnosis, etiology, genetics, clinical presentation, endoscopy, radiology, and best treatment of IFP.

关键词： Small bowel Inflammatory fibroid polyps Abdominal pain Intussusception Computed tomographyscan Surgery

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Treatment options of inflammatory appendiceal masses in adults

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World Journal of Gastroenterology 2013年第25期19卷 3942-3950页

作者： Jenny Tannoury bassam abboud Department of General Surgery Hotel Dieu de France Hospital Faculty of Medicine SaintJoseph University

At present, the treatment of choice for uncomplicated acute appendicitis in adults continues to be surgical. The inflammation in acute appendicitis may sometimes be enclosed by the patient's own defense mechanisms, by the formation of an inflammatory phlegmon or a circumscribed abscess. The management of these patients is controversial. Immediate appendectomy may be technically demanding. The exploration often ends up in an ileocecal resection or a right-sided hemicolectomy. Recently, the conditions for conservative management of these patients have changed due to the development of computed tomography and ultrasound, which has improved the diagnosis of enclosed inflammation and made drainage of intra-abdominal abscesses easier. New efficient antibiotics have also given new opportunities for nonsurgical treatment of complicated appendicitis. The traditional management of these patients is nonsurgical treatment followed by interval appendectomy to prevent recurrence. The need for interval appendectomy after successful nonsurgical treatment has recently been questioned because the risk of recurrence is relatively small. After successful nonsurgical treatment of an appendiceal mass, the true diagnosis is uncertain in some cases and an underlying diagnosis of cancer or Crohn's disease may be delayed. This report aims at reviewing the treatment options of patients with enclosed appendiceal inflammation, with emphasis on the success rate of nonsurgical treatment, the need for drainage of abscesses, the risk of undetected serious disease, and the need for interval appendectomy to prevent recurrence.

关键词： Appendicitis Phlegmon Abscess Computed tomography Antibiotics Percutaneous drainage Surgery

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