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Gastrointestinal tract injuries after thermal ablative therapies for hepatocellular carcinoma:A case report and review of the literature

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World Journal of Gastroenterology 2020年第35期26卷 5375-5386页

作者： Teresa Marzia Rogger Andrea Michielan Sandro Sferrazza Cecilia Pravadelli Luisa Moser Flora Agugiaro Giovanni Vettori sonia seligmann Elettra Merola Marcello Maida Francesco Antonio Ciarleglio Alberto Brolese Giovanni de Pretis Department of Surgery Gastroenterology and Digestive Endoscopy UnitSanta Chiara HospitalTrento 38122Italy Gastroenterology and Endoscopy Unit S.Elia-Raimondi HospitalCaltanissettaCaltanissetta 93100Italy Department of Surgery Hepato-biliary Surgery UnitSanta Chiara HospitalTrento 38122Italy

BACKGROUND Radiofrequency ablation(RFA)and microwave ablation(MWA)represent the standard of care for patients with early hepatocellular carcinoma(HCC)who are unfit for *** incidence of reported adverse events is low,ranging from 2.4%to 13.1%for RFA and from 2.6%to 7.5%for *** tract(GIT)injury is even more infrequent(0.11%),but usually requires surgery with an unfavourable *** to its low incidence and the retrospective nature of the studies,the literature reporting this feared complication is heterogeneous and in many cases lacks information on tumour characteristics,comorbidities and treatment *** SUMMARY A 77-year-old man who had undergone extended right hepatectomy for HCC was diagnosed with early disease recurrence with a small nodule compatible with HCC in the Sg4b segment of the liver with a subcapsular *** was treated with percutaneous RFA and a few week later he was urgently admitted to the Surgery ward for abdominal pain and fever.A subcutaneous abscess was diagnosed and treated by percutaneous drainage.A fistulous tract was then documented by the passage of contrast material from the gastric antrum to the abdominal *** oesophagogastroduodenoscopy confirmed a circular wall defect at the lesser curvature of gastric antrum, leading directly to the purulentabdominal collection. An over-the-scope clip (OTSC) was used to successfullyclose the defectCONCLUSIONThis is the first reported case of RFA-related GIT injury to have been successfullytreated with an OTSC, which highlights the role of this endoscopic treatment forthe management of this complication.

关键词： Gastrointestinal tract Radiofrequency ablation Hepatocellular carcinoma Complications Endoscopy Over-the-scope clip Case report

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Hepatitis C virus burden:Treating and educating people without prejudice

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World Journal of Hepatology 2022年第7期14卷 1495-1503页

作者： Elettra Merola Elisa Menotti Giovanna Branz Andrea Michielan sonia seligmann Annora Ratti Flora Agugiaro Luisa Moser Giovanni Vettori Anna Franceschini William Mantovani Riccardo Pertile Giovanni de Pretis Cecilia Pravadelli Department of Gastroenterology Santa Chiara HospitalAzienda Provinciale Per I Servizi Sanitari(APSS)Trento 38122Italy Department of SerD Service for Drug AddictionAzienda Provinciale Per I Servizi Sanitari(APSS)Trento 38122Italy Department of Prevention Azienda Provinciale Per I Servizi Sanitari(APSS)Trento 38122Italy Department of Clinical and Evaluative Epidemiology Azienda Provinciale Per I Servizi Sanitari(APSS)Trento 38122Italy

Hepatitis C virus(HCV)infection has a worldwide incidence of 1.1%.In Italy,60%of people who inject drugs(PWIDs)and are receiving assistance for substance use disorder are infected with ***,this subset of patients has extremely limited access to care due to multiple factors,including alcohol abuse,psychological comorbidities,and homeless *** To describe the impact of our HCV-dedicated service for substance use disorder(SSUD)service on PWIDs receiving anti-HCV *** A dedicated,multidisciplinary team was set up at the SSUD of Trento in October 2020 to provide antiviral treatment to HCV RiboNucleic Acid-positive patients with an active or previous history of substance *** treatment was followed by a health education *** were treated with Direct-Acting Antivirals(DAAs).Data were retrospectively analyzed to assess the efficacy of our dedicated program in terms of therapy completion,HCV eradication,and compliance(primary endpoint).The rate of HCV reinfection and DAA-related toxicity were also assessed(secondary endpoints).RESULTS A total of 40 patients were enrolled in the study:28(70.0%)were treated with Sofosbuvir/Velpatasvir,while 12(30.0%)received Glecaprevir/*** the time of inclusion in the study,36 patients were receiving opioid agonist maintenance therapy,whilst another 4 had just finished the treatment.37.5%had a history of alcoholism and 42.5%received concomitant psychiatric *** 40 patients(100.0%)completed the therapy cycle and 92.5%of patients adhered to the *** patients tested negative for viral load at the end of the *** were no significant drug interactions with common psychiatric treatments and no side effects were *** sustained virological response was achieved in 92.5%of cases with good tolerability,although two patients discontinued treatment *** HCV eradication,one patient died from an overdose,another from complications of cirrhosis,and one rein

关键词： Hepatitis C virus Service for substance use disorder Direct-acting antivirals Sustained virologic response Compliance Tolerability

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