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Primary gastroduodenal tuberculosis presenting as gastric outlet obstruction:A case report and review of literature

World Journal of Clinical Cases 2024年第8期12卷 1536-1543页

作者： Abdihamid Mohamed Ali Yahye Garad Mohamed Abdirahman Ahmed Mohamud Abdulkadir Nor Mohamed Mohamed Rage Ahmed Ismail Mohamud Abdullahi Tuba Saydam Department of General Surgery Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research HospitalMogadishu 2526Somalia Department of Radiology Mogadishu Somali TurkeyTraining and Research HospitalMogadishu 2526Somalia Department of Pathology Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research HospitalMogadishu 2526Somalia

BACKGROUND Mycobacterium tuberculosis(TB)is the causative agent of TB,a chronic granulo-matous *** disease is prevalent in low-income countries,posing a significant global health *** TB is one of the three *** disease can mimic other intra-abdominal conditions,leading to delayed diagnosis owing to the absence of specific *** gastric outlet obs-truction(GOO)remains a frequent complication,its incidence has declined with the advent of proton pump inhibitors and Helicobacter pylori eradication *** TB can cause upper gastrointestinal hemorrhage,obstruction,and malignancy-like *** SUMMARY A 23-year-old male presented with recurrent epigastric pain,distension,nausea,vomiting,and weight loss,prompting a referral to a gastroenterologist *** examination revealed distorted gastric mucosa and signs of chronic ***,treatment was interrupted,possibly owing to vomiting or comorbidities such as human immunodeficiency virus infection or *** surgical intervention revealed a dilated stomach and diffuse thickening of the duodenal *** revealed gastric wall effacement with *** Primary gastric TB is rare,frequently leading to *** its rarity,suspicions should be promptly raised when encountering relevant symptoms,often requiring surgical intervention for diagnosis and treatment.

关键词： Tuberculosis Gastrointestinal tuberculosis gastric outlet obstruction Gastroduodenal tuberculosis Case report

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Endoscopic ultrasound-guided gastroenterostomy for gastric outlet obstruction in Mexico

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World Journal of Surgical Procedures 2024年第3期14卷 15-20页

作者： Massiel Madelin Rosario-Morel Rodrigo Soto-Solis Katia Picazo-Ferrera Miriam Idalia Torres-Ruiz JoséAlberto Estradas-Trujillo Mario Alberto Gallardo-Ramírez Gerardo Akram Darwich-del Moral Luis Ariel Waller-González Department of Endoscopy Centro Médico Nacional“20 de Noviembre”ISSSTEMexico City 03229Mexico Department of Gastroenterology HospitalÁngeles PedregalMexico City 10700Mexico Department of Endoscopy Centro Médico ABCMexico City 01120Mexico Department of Endoscopy Hospital General de México“Dr.Eduardo Liceaga”Mexico City 06720Mexico

BACKGROUND Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)has recently emerged as an alternative treatment for gastric outlet obstruction(GOO)in selected *** To report the initial experience of EUS-GE in patients with *** This study was a retrospective,observational,multicenter study in which the data from 10 patients who underwent EUS-GE due to GOO between September 2021 and May 2023 were *** analyzed technical success,clinical success,adverse events,and *** success was defined as adequate positioning and deployment of the *** success was defined as the patient’s ability to tolerate oral intake without vomiting 7 d after the *** adverse events were *** Eleven procedures in 10 patients with GOO were *** mean age of the patients was 67.5 years(range:56-77 years).Malignant GOO was present in 9 *** success was achieved in 9/11 procedures(82%).Among them,clinical success was achieved in 9 patients(100%).Adverse events occurred in 1 patient(9%).The median survival was 3 months(n=7;range:1-8 months).CONCLUSION EUS-GE is a feasible therapeutic option in the treatment of GOO.

关键词： Endoscopic ultrasound-guided gastroenterostomy gastric outlet obstruction Lumen apposing metal stent Interventional endoscopic ultrasound Gastrojejunostomy Duodenal stenting

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Palliative Therapy for gastric outlet obstruction Caused by Unresectable gastric Cancer： A Meta-analysis Comparison of Gastrojejunostomy with Endoscopic Stenting

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Chinese Medical Journal 2016年第9期129卷 1113-1121页

作者： Shi-Bo Bian Wei-Song Shen Hong-Qing Xi Bo Wei Lin Chen Department of General Surgery Chinese People's Liberation Army General Hospital Beijing 100853 China

Background： Gastrojejunostomy （G J J） and endoscopic stenting （ES） are palliative treatments for gastric outlet obstruction （GO0） caused by gastric cancer. We compared the outcomes of GJJ with ES by performing a meta-analysis. Methods： Clinical trials that compared GJJ with ES for the treatment of GOO in gastric cancer were included in the meta-analysis. Procedure time, time to resumption of oral intake, duration of hospital stay, patency duration, and overall survival days were compared using weighted mean differences （WMDs）. Technical success, clinical success, procedure-related mortality, complications, the rate of re-obstruction, postoperative chemotherapy, and reintervention were compared using odds ratios （ORs）.Results： Nine studies were included in the analysis. Technical success and clinical success were not significantly different between the ES and GJJ groups. The ES group had a shorter procedure time （WMD = -80.89 min, 95% confidence interval [CI] = -93.99 to -67.78, P 〈 0.001）, faster resumption of oral intake （WMD = -3.45 days, 95% CI = -5.25 to -1.65, P 〈 0.001）, and shorter duration of hospital stay （WMD = -7.67 days, 95% CI = -11.02 to -4.33, P 〈 0.001）. The rate of minor complications was significantly higher in the GJJ group （OR = 0.13, 95% CI = 0.04-0.40, P 〈 0.001）. However, the rates of major complications （OR = 6.91, 95% CI = 3.90-12.25, P 〈 0.001）, re-obstruction （OR = 7.75, 95% CI = 4.06-14.78, P 〈 0.001）, and reintervention （OR = 6.27, 95% CI = 3.36-11.68, P 〈 0.001） were significantly lower in the GJJ group than that in the E S group. Moreover, GJJ was significantly associated with a longer patency duration （WMD = -167.16 days, 95% CI = -254.01 to -89.31, P 〈 0.001） and overall survival （WMD = -103.20 days, 95% CI = -161.49 to -44.91, P = 0.001）. Conclusions： Both GJJ and ES are effective procedures for the treatment of GOO caused by gastric cancer. ES is associated with better short-term outcomes. GJJ is preferable to ES in terms of its lo

关键词： Endoscopic Stenting gastric Cancer gastric outlet obstruction Gastrojejunostomy

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Conservative management of malignant gastric outlet obstruction syndrome-evidence based evaluation of endoscopic ultrasoundguided gastroentero-anastomosis

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World Journal of Gastrointestinal Oncology 2021年第9期13卷 1086-1098页

作者： Anna Cominardi Giacomo Tamanini Nicole Brighi Pietro Fusaroli Andrea Lisotti Department of Gastroenterology Unit Hospital of ImolaUniversity of BolognaImola 40026BOItaly Department of Medical Oncology Istituto Scientifico Romagnolo Per Lo Studio Dei Tumori“Dino Amadori”(IRST)IRCCSMeldola 47014FCItaly Department of Medical and Surgical Sciences University of Bologna/Hospital of ImolaBologna 40121Italy

gastric outlet obstruction(GOO)is a clinical syndrome characterized by postprandial vomiting,abdominal pain,bloating and,in advanced cases,by weight loss secondary to inadequate oral *** clinical entity may be caused by mechanical obstruction,either benign or malignant,or by motility *** this review we will focus on malignant GOO and on its endoscopic ultrasound(EUS)-guided palliative *** most frequent malignant causes of this syndrome are gastric and locally advanced pancreatic carcinomas;other causes include duodenal or ampullary neoplasms,gastric lymphomas,retroperitoneal lymphadenopathies and,more infrequently,gallbladder and bile duct *** represents the treatment of choice when radical and curative resection is potentially feasible;if the malignant cause is not likely to be completely resected,palliative treatments should be *** treatments for malignant GOO are primarily based on surgical gastro-jejunostomy and endoscopic placement of an enteral self-expanding metal *** treatments are effective;however,endoscopic stent placement is less invasive and it is associated with good short-term results,while surgery provides longer-lasting effects with a lower frequency of *** the last few years,EUS-guided gastroenterostomy(GE)has been proposed as palliative treatment for malignant *** novel technique consists of the creation of an anastomosis between the gastric lumen and a small bowel loop distal to the malignant obstruction,through the deployment of a lumen-apposing metal stent under ***-GE has the advantage of being as minimally invasive as enteral stent placement,and of guaranteeing long-term results similar to those of surgery.

关键词： gastric outlet obstruction Endoscopic ultrasound-guided gastroenterostomy Endoscopic ultrasound Enteric anastomosis Lumen-apposing metal stents

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gastric partitioning for the treatment of malignant gastric outlet obstruction

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World Journal of Gastrointestinal Oncology 2019年第12期11卷 1161-1171页

作者： Marcus Fernando Kodama Pertille Ramos Leandro Cardoso Barchi Rodrigo Jose de Oliveira Marina Alessandra Pereira Donato Roberto Mucerino Ulysses Ribeiro Jr Bruno Zilberstein Ivan Cecconello Department of Gastroenterology Hospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao Paulo

BACKGROUND gastric outlet obstruction(GOO)is one of the main complications in stage IV gastric cancer *** condition is usually managed by gastrojejunostomy(GJ).However,gastric partitioning(GP)has been described as an alternative to overcoming possible drawbacks of GJ,such as delayed gastric emptying and tumor *** To compare the outcomes of patients who underwent GP and GJ for malignant *** We retrospectively analyzed 60 patients who underwent palliative gastric bypass for unresectable distal gastric cancer with GOO from 2009 to *** clinicopathological characteristics including age,nutritional status,body mass index,and performance status were *** symptoms were graded according to GOO score(GOOS).Surgical outcomes evaluated included duration of the procedure,surgical complications,mortality,and length of hospital *** of oral diet after the procedure,weight gain,and overall survival were the long-term outcomes *** GP was performed in 30 patients and conventional GJ in the other 30 *** mean follow-up was 9.2 ***-nine(81.6%)patients died during that *** variables were similar between groups,with the exception of worse performance status in GP *** mean operative time was higher in the GP group(161.2 vs 85.2 min,P<0.001).There were no differences in postoperative complications and surgical mortality between *** median overall survival was 7 and 8.4 mo for the GP and GJ groups,respectively(P=0.610).The oral acceptance of soft solids(GOOS 2)and low residue or full diet(GOOS 3)were reached by 28(93.3%)GP patients and 22(75.9%)GJ patients(P=0.080).Multivariate analysis demonstrated that GOOS 2 and GOOS 3 were the main prognostic factors for survival(hazard ratio:8.90,95%confidence interval:3.38-23.43,P<0.001).CONCLUSION GP is a safe and effective procedure to treat *** to GJ,it provides similar surgical outcomes with a trend to better solid diet accep

关键词： Stomach neoplasms gastric outlet obstruction Palliative surgery Gastrojejunostomy gastric cancer

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Effect of preoperative nutrition therapy type and duration on short-time outcomes in gastric cancer patient with gastric outlet obstruction

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Chinese Journal of Cancer Research 2021年第2期33卷 232-242页

作者： Jiyang Li Shaoqing Li Hongqing Xi Peifa Liu Wenquan Liang Yunhe Gao Chuang Wang Bo Wei Lin Chen Yun Tang Zhi Qiao Department of General Surgery the First Medical CenterChinese PLA General HospitalBeijing 100853China Liposuction Center of Plastic Surgery Hospital Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100144China

Objective:To avoid perioperative complications caused malnutrition,nutrition therapy is necessary in gastric outlet obstruction(GOO)*** to parenteral nutrition(PN),enteral nutrition(EN)is associated with many *** study aimed to investigate whether preoperative EN has beneficial clinical effects compared to preoperative PN in gastric cancer patients with GOO undergoing ***:According to the methods of preoperative nutrition therapy,143 patients were divided into EN group(n=42)and PN group(n=101)between January 2013 and December 2017 at the Chinese People’s Liberation Army General *** logistic regression models were used to assess the association between the methods of preoperative nutrition therapy and postoperative day of flatus *** generalized additive model and twopiecewise linear regression model were used to calculate the inflection point of the preoperative nutritional therapy time on the postoperative day of flatus passage in the PN ***:EN shortened the postoperative day of flatus passage in gastric cancer patients with GOO,which is a protective factor,especially in patients who underwent non-radical operations and the postoperative day of flatus passage reduced when the preoperative PN therapy was up to 3 d and a longer PN therapy(>3 d)did not accelerate the postoperative recovery of gastrointestinal ***:Preoperative EN therapy would benefit gastric cancer patients with GOO by accelerating postoperative *** patients with absolute obstruction,no more than 3-day PN therapy is recommended if patients can tolerate general anesthesia and surgery.

关键词： Nutrition therapy gastric cancer gastric outlet obstruction enteral nutrition parenteral nutrition

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gastric outlet obstruction by a Hydrocholecyst. A Very Rare Variant of Bouveret Syndrome: A Case Report

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Surgical Science 2021年第9期12卷 332-337页

作者： Luis Daniel Betancourt Martínez Alberto Manuel González Chávez Mario Andrés González Chávez Jiroyoshi Enrique Muneta Kishigami Abraham Samra Saad General Surgery Department Hospital Espa&#241ol Mexico City Mexico Gastroenterology Department Hospital Espa&#241ol Mexico City Mexico Geriatric Medicine Department Hospital Espa&#241ol Mexico City Mexico

It is estimated that between 0.3% - 0.5% of patients with cholelithiasis have biliary ileus, of this small proportion, only between 1% - 3% is complicated by the syndrome described in 1896 by Leon Bouveret. Bouveret syndrome refers to the obstruction of the gastric outlet tract secondary to the passage and impactation of a gallstone in the duodenum, through a cholecystoduodenal fistula. It is most common in women, between the ages of 74 - 77 and is clinically characterized by pain, bloating, incoercible vomiting and anorexia.

关键词： Bouveret Syndrome gastric outlet obstruction Gallstone Hydrocholecyst Cholelithiasis Gastromegaly

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Endoscopic ultrasound guided gastrojejunostomy for gastric outlet obstruction

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World Journal of Gastrointestinal Surgery 2021年第7期13卷 620-632页

作者： Sebastian Stefanovic Peter V Draganov Dennis Yang Department of Gastroenterology and Hepatology University Medical Center LjubljanaLjubljana 1000Slovenia Division of Gastroenterology Hepatologyand NutritionUniversity of Florida College of MedicineGainesvilleFL 32608United States

gastric outlet obstruction(GOO)is a clinical syndrome secondary to luminal obstruction at the level of the stomach and/or *** can be caused by either benign or malignant etiologies,often resulting in early satiety,nausea,vomiting and poor oral *** is associated with decreased quality of life and has been shown to significantly impact survival in patients with advanced *** treatment options for GOO can be broadly divided into surgical[surgical gastrojejunostomy(GJ)]and endoscopic interventions(dilation and/or placement of luminal self-expanding metal stents).While surgical GJ has been shown to provide a more lasting relief of symptoms when compared to luminal stenting,it has also been associated with a higher rate of adverse ***,many patients with advanced metastatic disease are not good surgical *** recently,endoscopic ultrasound(EUS)-guided GJ has emerged as a potential alternative to traditional surgical and endoscopic *** review focuses on the new advances and technical aspects of EUS-GJ and clinical outcomes in the management of both benign and malignant disease.

关键词： gastric outlet obstruction Interventional endoultrasonography Gastrojejunostomy Duodenal stenting Balloon dilatation

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Modified stomach-partitioning gastrojejunostomy for initially unresectable advanced gastric cancer with outlet obstruction: A case report

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World Journal of Gastrointestinal Surgery 2023年第6期15卷 1247-1255页

作者： Xin-Xin Shao Quan Xu Bing-Zhi Wang Yan-Tao Tian Department of Pancreatic and gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Pathology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND Chemotherapy followed by gastrojejunostomy remains the main treatment for unresectable gastric cancer(GC)in the middle-or lower-third regions with gastric outlet obstruction(GOO).Radical surgery is performed as part of a multimodal treatment strategy for selected patients who respond well to *** study describes a case of successful radical resection with completely laparoscopic subtotal gastrectomy after a modified stomach-partitioning gastrojejunostomy(SPGJ)for obstruction relief,in a patient with *** SUMMARY During the initial esophagogastroduodenoscopy,an advanced growth was detected in the lower part of the stomach,which caused an obstruction in the pyloric *** this,a computed tomography(CT)scan revealed the presence of lymph node metastases and tumor invasion in the duodenum,but no evidence of distant metastasis was ***,we performed a modified SPGJ,a complete laparoscopic SPGJ combined with No.4sb lymph node dissection,for obstruction *** courses of adjuvant capecitabine plus oxaliplatin combined with Toripalimab(programmed death ligand-1 inhibitor)were administered thereafter.A preoperative CT showed partial response;therefore,completely laparoscopic radical subtotal gastrectomy with D2 lymphadenectomy was performed after conversion therapy,and pathological complete remission was *** Laparoscopic SPGJ combined with No.4sb lymph node dissection was an effective surgical technique for initially unresectable GC with GOO.

关键词： Gastrojejunostomy gastric cancer gastric outlet obstruction Conversion therapy Curative resection Case report

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Management of gastric outlet obstruction:Focusing on endoscopic approach

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2020年第2期11卷 8-16页

作者： Su Jin Jeong Jin Lee Division of Gastroenterology Department of Internal MedicineInje University Haeundae Paik HospitalBusan 48108South Korea

gastric outlet obstruction(GOO)is a medical condition characterized by epigastric pain and postprandial vomiting due to mechanical *** obstructions typically involved in GOO can be benign or *** ulcer disease is the most common cause of benign GOO,and malignant causes include gastric cancer,lymphoma,and gastrointestinal stromal *** the eradication of Helicobacter pylori(***)and the use of proton pump inhibitors,the predominant causes have changed from benign to malignant *** of GOO depends on the underlying cause:Proton pump inhibitors,*** eradication,endoscopic treatments including balloon dilatation or the placement of self-expandable stents,or surgery.

关键词： gastric outlet obstruction Balloon dilation Metal stent

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