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Colon mucosal injury caused by water jet malfunction during a screening colonoscopy:A case report

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World Journal of Clinical Cases 2022年第33期10卷 12375-12379页

作者： parth patel Chien-Huan Chen Division of Gastroenterology Department of Internal MedicineWashington University School of MedicineSt.LouisMO 63110United States

BACKGROUND Screening colonoscopies are routinely performed and have low occurrences of adverse events such as perforation,bleeding,infection,and post-polypectomy *** device related adverse events are rarely reported in the *** SUMMARY We report a case of a 51-year-old patient without past medical history who presented for her first screening *** patient was thought to have friable mucosa in the cecum and oozed upon water irrigation during screening *** was later identified that the colonoscope used during the index procedure had malfunctioned and produced a pin-point water jet which damaged the colon mucosa of *** maintenance service identified a piece of rubber fragment lodged in the instrument component at the tip of the scope,resulting in high pressure water *** colonoscopy with a functioning colonoscope confirmed normal colon mucosa without *** This is the first report of mucosa injury from a colonoscope water jet *** should recognize the potential for endoscopic malfunction.

关键词： Iatrogenic disease Colonoscopy Water jet injury Friable colon mucosa Case report

De novo non-alcoholic fatty liver disease after pancreatectomy:A systematic review

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World Journal of Clinical Cases 2022年第35期10卷 12946-12958页

作者： parth Shah Vanisha patel Motaz Ashkar Gastroenterology Washington University in Saint LouisSaint LouisMO 63110United States Internal Medicine Washington University in Saint LouisSaint LouisMO 63110United States

BACKGROUND As operative techniques and mortality rates of pancreatectomy have improved,there has been a shift in focus to maintaining and improving the nutritional status of these patients as we continue to learn more about post-operative *** pancreatic endocrine and exocrine insufficiencies are known complications of pancreatectomy,increased longevity of these patients has also led to a higher incidence of de novo fatty liver disease which differs from traditional fatty liver disease given the lack of metabolic *** To identify and summarize patterns and risk factors of post-pancreatectomy de novo fatty liver disease to guide future *** We performed a database search on PubMed selecting papers published between 2001 and 2022 in the English *** was last accessed 1 June *** Various factors influence the development of de novo fatty liver including indication for surgery(benign vs malignant),type of pancreatectomy,amount of pancreas remnant,and peri-operative nutritional *** an incidence rate up to 75%,de novo non-alcoholic fatty liver disease(NAFLD)can develop within 12 mo after pancreatectomy and various risk factors have been established including pancreatic resection line and remnant pancreas volume,peri-operative malnutrition and weight loss,pancreatic exocrine insufficiency(EPI),malignancy as the indication for surgery,and postmenopausal *** Since majority of risk factors leads to EPI and malnutrition,peri-operative focus on nutrition and enzymes replacement is key in preventing and treating de novo NAFLD after pancreatectomy.

关键词： Pancreatectomy De novo fatty liver Pancreatic Insufficiency Malnutrition

Impact of hospital volume on outcomes of percutaneous ASD/PFO closure in pediatric patients

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World Journal of Pediatrics 2018年第4期14卷 364-372页

作者： parth Bhatt Achint patel Varun Kumar Anusha Lekshminarayanan Viranchi patel Srilatha Alapati Zeenia Cyrus Billimoria Texas Tech University Health Sciences Center AmarilloTXUSA University of Arkansas for Medical Sciences Little RockARUSA Mt.Sinai St.Luke's Roosevelt Hospital Center New YorkNYUSA Mercy Health CincinnatiOHUSA Tulane University School of Public Health and Tropical Medicine New OrleansLAUSA University of Washington Seattle Children's Hospital4800 Sand Point Way NESeattleWA 98105USA

Background We investigated the effect of hospital volume on percutaneous closure of atrial septal defect/patent foramen ovale (ASD) among pediatric patients. Methods We identified patients undergoing percutaneous closure of ASD with device using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure code 35.52 from the National Inpatient Sample, years 2002–2011. Patients with age ≤ 18 years and primary diagnosis code 745.5 for ASD were included. Hospital volume was calculated using unique identification numbers and divided into tertiles for analysis. Multivariate regression analysis was performed to determine independent predictors of procedure-related complications which were coded using specific codes released by Healthcare Cost and Utilization Project. Results 6162 percutaneous ASD closure procedures were analyzed. There was no mortality associated with percutaneous ASD closure. Cardiac complications (9.5%) were most common. On multivariate analysis, age increment of 3 years decreased the odds of developing complications (OR 0.83, 95% CI 0.79–0.87,P < 0.001). Odds of developing complications in the 2nd (OR 0.74, 95% CI 0.62–0.89,P = 0.007) and 3rd tertiles (OR 0.34, 95% CI 0.27–0.42,P < 0.001) were lower as compared to the 1st tertile of hospital volume. Conclusion Increasing annual hospital volume is an independent predictor of lower complication rates in percutaneous ASD closure cases with no associated mortality in pediatric patients.

关键词： Atrial septal defect Cardiac catheterization Children

Artificial intelligence and colonoscopy − enhancements and improvements

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Artificial Intelligence in Gastrointestinal Endoscopy 2021年第4期2卷 157-167页

作者： Byung Soo Yoo Steve M D'Souza Kevin Houston Ankit patel James Lau Alsiddig Elmahdi parth J Parekh David Johnson Department of Medicine Eastern Virginia Medical SchoolNorfolkVA 23507United States Division of Gastroenterology Department of Internal MedicineEastern Virginia Medical SchoolNorfolkVA 23505United States

Artificial intelligence is a technology that processes and analyzes information with reproducibility and *** application in medicine,especially in the field of gastroenterology,has great potential to facilitate in diagnosis of various disease ***,the role of artificial intelligence as it pertains to colonoscopy revolves around enhanced polyp detection and *** aim of this article is to review the current and potential future applications of artificial intelligence for enhanced quality of detection for colorectal neoplasia.

关键词： Artificial intelligence Colon polyp Adenoma detection rate Dysplasia Inflammatory bowel disease Colon preparation