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Device-assisted enteroscopy: Are we ready to dismiss the spiral?

World Journal of Gastroenterology 2024年第26期30卷 3185-3192页

作者： Alessandro Mussetto Elettra Merola Cesare Casadei Daniele Salvi Fabiola Fornaroli Silvia Cocca Margherita Trebbi Armando Gabbrielli Cristiano Spada Andrea Michielan Department of Gastroenterology S Maria della Croci HospRavenna 48121Italy Department of Gastroenterology unit G.B.Grassi Hospital(ASL Roma 3)Roma 00122Italy Section of Digestive endoscopy and Gastroenterology Fondazione PoliambulanzaBrescia 25124Italy Gastroenterology and endoscopy unit Department of Medicine and SurgeryUniversity of ParmaParma 43125Italy Gastroenterology and endoscopy unit Azienda Ospedaliero Universitaria Policlinico di ModenaModena 41121Italy Center for Medical Sciences(CISMed) University of TrentoTrento 38122Italy Gastroenterology and Digestive endoscopy unit Santa Chiara HospitalAzienda Provinciale per i Servizi SanitariTrento 38122Italy Digestive endoscopy unit Fondazione Policlinico Universitario A.Gemelli IRCSSRoma 00168Italy

Motorized spiral enteroscopy(MSE)is the latest advance in device-assisted *** events related to MSE were discussed in a recent large systematic review and meta-analysis and were directly compared with those of balloon enteroscopy in a case-matched study and a randomized controlled *** the real-life application of MSE,an unexpected safety issue emerged regarding esophageal injury and the technique has been withdrawn from the global market,despite encouraging results in terms of diagnostic and therapeutic *** conducted an Italian multicenter real-life prospective study,which was prematurely terminated after the withdrawal of MSE from the *** primary goals were the evaluation of MSE performance(both diagnostic and therapeutic)and its safety in routine endoscopic practice,particularly in the early phase of introduction in the endoscopic unit.A subanalysis,which involved patients who underwent MSE after unsuccessful balloon enteroscopy,demonstrated,for the first time,the promising performance of MSE as a rescue *** its remarkable performance in clinical practice and its potential role as a backup technique following a previously failed enteroscopy,it may be more appropriate to refine and enhance MSE in the future rather than completely abandoning it.

关键词： Motorized spiral enteroscopy Rescue enteroscopy Diagnostic yield Adverse events AGREE classification

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Two big orifices in the second duodenal portion:A case of an atypical double papilla

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 83-85页

作者： Salvatore Francesco Vadalàdi Prampero Nikola Panic Marco Massidda Chiara Rocchi Pierluigi Maria Rinaldi Ana Malenkovic Milutin Bulajic Gastroenterology and GI endoscopy Department Mater Olbia HospitalOlbia 07026Italy Digestive endoscopy unit University Clinic"Dr Dragisa Misovic-Dedinje"Belgrade 11000Serbia Radiology Department Mater Olbia HospitalOlbia 07026Italy

With the advent of endoscopic retrograde cholangiopancreatography(ERCP)in the early 1970s,anatomic anomalies of the Vaterian system were described endoscopically[1].Although the occurrence is rare,the common bile duct(CBD)and the pancreatic duct may fail to coalesce during embryologic *** leads to double major papilla because both ducts open into the duodenum separately[1].In this way the cranial duct communicates with the CBD,while the caudal orifice communicates with the pancreatic duct[2].

关键词： orifice Vater atypical

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Comments on the editorial by Riggio&Ageloni on the ascitic fluid analysis

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World Journal of Gastroenterology 2009年第48期15卷 6137-6138页

作者： Anastasios Koulaouzidis day case & endoscopy unit Centre of Liver and Digestive DisordersRoyal Infirmary of Edinburgh

Angeloni et al published a landmark study on the use of Coulter counters in spontaneous bacterial peritonitis(SBP)*** and Angeloni have recently published an editorial on the ascitic fluid analysis in diagnosis and mo... 详细信息

关键词： Peritonitis Reagent Dipstick Paracentesis Guidelines Ascites

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Propensity score matching analysis for clinical impact of braided-type versus laser-cut-type covered self-expandable metal stents for endoscopic ultrasound-guided hepaticogastrostomy

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 181-185页

作者： Mitsuki Tomita Takeshi Ogura Akitoshi Hakoda Saori Ueno Atsushi Okuda Nobu Nishioka Yoshitaro Yamamoto Hiroki Nishikawa 2nd Department of Internal Medicine Osaka Medical and Pharmaceutical UniversityOsakaJapan endoscopy Center Osaka Medical and Pharmaceutical UniversityOsakaJapan

Background:To prevent stent migration during endoscopic ultrasound-guided hepaticogastrostomy(EUS-HGS),intra-scope channel release technique is important,but is unfamiliar to non-expert *** self-expandable metal stent(SEMS)is an additional factor to prevent stent ***,no compara-tive studies of laser-cut-type and braided-type during EUS-HGS have been *** aim of this study was to compare the distance between the intrahepatic bile duct and stomach wall after EUS-HGS among laser-cut-type and braided-type ***:To evaluate stent anchoring function,we measured the distance between the hepatic parenchyma and stomach wall before EUS-HGS,one day after EUS-HGS,and 7 days after ***,propensity score matching was performed to create a propensity score for using laser-cut-type group and braided-type ***:A total of 142 patients were enrolled in this *** them,24 patients underwent EUS-HGS using a laser-cut-type SEMS,and 118 patients underwent EUS-HGS using a braided-type ***-HGS using the laser-cut-type SEMS was mainly performed by non-expert endoscopists(n=21);EUS-HGS using braided-type SEMS was mainly performed by expert endoscopists(n=98).The distance after 1 day was significantly shorter in the laser-cut-type group than that in the braided-type group[2.00(1.70-3.75)vs.6.90(3.72-11.70)mm,Pdays was increased by 4 mm compared with the distance after 1 day in the braided-type *** the other hand,in the laser-cut-type group,the distance after 1 day and 7 days was almost the ***:EUS-HGS using a laser-cut-type SEMS may be safe to prevent stent migration,even in non-expert hands.

关键词： Endoscopic ultrasound-guided hepaticogastrostomy Endoscopic ultrasound-guided biliary drainage Endoscopic retrograde cholangiopancreatography

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Non-improvement of atrophic gastritis in cases of gastric cancer after successful Helicobacter pylori eradication therapy

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World Journal of Clinical cases 2024年第14期12卷 2342-2349页

作者： Yuto Suzuki Yasumi Katayama Yo Fujimoto Ikuhiro Kobori Masaya Tamano Department of Gastroenterology Dokkyo medical University Saitama Medical CenterKoshigayaSaitama 343-8555Japan endoscopy Center Dokkyo Medical University Saitama Medical CenterKoshigayaSaitama 343-8555Japan

BACKGROUND Helicobacter pylori(***)infection is closely related to the development of gastric cancer(GC).However,GC can develop even after *** ***,it would be extremely useful if GC could be predicted after *** Kyoto classification score for gastritis(GA)is closely related to cancer ***,how the score for GC changes after eradication before onset is not well *** To investigate the characteristics of the progression of Kyoto classification scores for GC after *** *** Eradication of *** was confirmed in all patients using either the urea breath test or the stool antigen *** Kyoto classification score of GC patients was evaluated by endoscopy at the time of event onset and three years *** ad-dition,the modified atrophy score was evaluated and compared between the GC group and the control GA *** In total,30 cases of early GC and 30 cases of chronic GA were *** pathology of the cancer cases was differentiated adenocarcinoma,except for one case of undifferentiated *** total score of the Kyoto classifi-cation was significantly higher in the GC group both at the time of cancer onset and three years earlier(4.97 vs 3.73,P=0.0034;4.2 vs 3.1,P=0.0035,respectively).The modified atrophy score was significantly higher in the GC group both at the time of cancer onset and three years earlier and was significantly improved only in the GA group(5.3 vs 5.3,P=0.5;3.73 vs 3.1,P=0.0475,respectively).CONCLUSION The course of the modified atrophy score is useful for predicting the onset of GC after *** with severe atrophy after *** eradication require careful monitoring.

关键词： Helicobacter pylori Kyoto classification Gastritis Eradication therapy Gastric cancer

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Primary anaplastic lymphoma kinase-positive large B-cell lymphoma of the left bulbar conjunctiva: A case report

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World Journal of Clinical cases 2024年第3期12卷 657-664页

作者： Xiao-Hong Guo Chu-Bin Li Hui-Hui Cao Gen-Yuan Yang Department of Pathology Zhuhai People's Hospital(Zhuhai Hospital Affiliated with Jinan University)Zhuhai 519000Guangdong ProvinceChina endoscopy Center Zhuhai People's Hospital(Zhuhai Hospital Affiliated with Jinan University)Zhuhai 519000Guangdong ProvinceChina

BACKGROUND Anaplastic lymphoma kinase(ALK)-positive large B-cell lymphoma(LBCL)is an aggressive and rare variant of diffuse ***,we report an uncommon case of stage IE extranodal ALK-positive LBCL initially originating in the bulbar *** SUMMARY A 63-year-old woman presented with a mass in the left bulbar conjunctiva that had persisted for six months,accompanied by swelling and pain that had per-sisted for 3 *** examination revealed an 8 mm slightly elevated pink mass in the lower conjunctival sac of the left ***,the tumor was com-posed of large immunoblastic and plasmablastic large lymphoid cells with scattered anaplastic or multinucleated large ***,the neoplastic cells were positive for ALK,CD10,CD138,Kappa,MUM1,BOB.1,OCT-2,CD4,CD45,EMA,CD79a,CD38,and AE1/AE3,and negative for CD20,PAX5,Lambda,BCL6,CD30 and all other T-cell *** results of gene rearrangement tests showed monoclonal IGH/IGK/IGL and TCRD *** in situ hybridization studies did not reveal any BCL2,BCL6 or MYC ***,Epstein-Barr virus was not detected by in situ hybridization in the *** on the histopathological and imaging examinations,the neoplasm was classified as stage IE ALK-positive *** further treatments were *** the 6,15,and 21 mo postoperative follow-up visits,the patient was in good condition,without obvious *** case represents the first example of primary extranodal ALK-positive LBCL presenting as a bulbar conjunctival mass,which is extremely rare and shares morphological and immunohistochemical features with a variety of other neo-plasms that can result in *** Awareness of the condition presented in this case report is necessary for early and accurate diagnosis and appropriate treatment.

关键词： Anaplastic lymphoma kinase Large B-cell lymphoma Conjunctiva Immunoglobulin/T-cell receptor gene Immunohistochemistry case report

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Asymptomatic low-grade appendiceal mucinous neoplasm:A case report

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World Journal of Clinical cases 2024年第2期12卷 361-366页

作者： Min-Quan Yao Yu-Peng Jiang Yuan-Yu Wang Yi-Ping Mou Jin-Xing Fan Department of Gastrointestinal Surgery Tongxiang First People’s HospitalJiaxing 314500Zhejiang ProvinceChina Department of General Surgery Zhejiang Provincial People’s HospitalHangzhou 310014Zhejiang ProvinceChina endoscopy Center Tongxiang First People’s HospitalJiaxing 314500Zhejiang ProvinceChina

BACKGROUND Low-grade appendiceal neoplasms(LAMN)are characterized by low incidence and atypical clinical presentations,often leading to misdiagnosis as acute or chronic appendicitis before *** primary diagnostic tool for LAMN is abdominal computed tomography(CT)*** resection remains the cornerstone of LAMN management,necessitating en bloc tumor excision to minimize the risk of iatrogenic ***,known for its minimal invasiveness,reduced postoperative discomfort,and expedited recovery,is a safe and reliable approach for LAMN *** the possibility of pseudomyxoma peritonei development,appendectomy and partial appendectomy generally result in negative tumor margins and favorable outcomes,which can be attributed to the disease’s slow growth and lower *** SUMMARY A 71-year-old male patient was admitted to our hospital with a pelvic spaceoccupying lesion detected 1 mo *** examination showed a soft abdomen without tenderness or rebound and no palpable *** shifting dullness was noted,and digital rectal examination revealed no palpable *** revealed a raised,smooth-surfaced mass measuring 3.0 cm in the *** contrast-enhanced CT showed a markedly thickened and dilated appendix with visible cystic *** surgery was performed and revealed a significantly dilated appendix,leading to laparoscopic resection of the appendix and part of the ***-surgical pathologic analysis confirmed *** patient received symptomatic and supportive post-operative care and was discharged on postoperative day 4 without complications such as abdominal bleeding,intestinal obstruction,or incision *** tumor recurrence was observed during a 7-mo follow-up *** LAMN is a rare disease that lacks specific clinical *** CT plays a crucial role in diagnosing LAMN,and laparoscopic surgery is a safe and effective diagnostic and therapeutic approach.

关键词： Low-grade appendiceal mucinous neoplasm Pseudomyxoma peritonei Computed tomography Laparoscopy appendectomy case report

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Predictive performance of the variation rate of the driving pressure on the outcome of invasive mechanical ventilation in patients with acute respiratory distress syndrome

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Chinese Journal of Traumatology 2024年第2期27卷 107-113页

作者： Hui-Dan Jing Jun-Ying Tian Wei Li Bing-Ling He Hong-Chao Li Fu-Xia Jian Cui Shang Feng Shen Department of Intensive Care unit The Affiliated Hospital of Guizhou Medical UniversityGuiyang 550004China Department of Intensive Care unit Army Medical Center of PLAChongqing400042China College of Foreign Languges Chongqing Medical UniversityChongqing400016China

Purpose:To assess the value of the driving pressure variation rate(ΔP%)in predicting the outcome of weaning from invasive mechanical ventilation in patients with acute respiratory distress ***:In this case-control study,a total of 35 patients with moderate-severe acute respiratory distress syndrome were admitted to the intensive care unit between January 2022 and December 2022 and received invasive mechanical ventilation for at least 48 h were *** were divided into successful weaning group and failed weaning group depending on whether they could be removed from ventilator support within 14 *** measures including driving pressure,PaO2:FiO2,and positive end-expiratory pressure,*** assessed every 24 h from day 0 to day 14 until successful weaning was *** measurement data of non-normal distribution were presented as median(Q1,Q3),and the differences between groups were compared by Wilcoxon rank sum *** categorical data use the Chi-square test or Fisher's exact test to *** predictive value ofΔP%in predicting the outcome of weaning from the ventilator was analyzed using receiver operating characteristic ***:Of the total 35 patients included in the study,17 were successful vs.18 failed in weaning from a ventilator after 14 days of mechanical *** cut-off values of the medianΔP%measured by Operator 1 *** 2 in the first 4 days were≥4.17%and 4.55%,respectively(p<0.001),with the area under curve of 0.804(sensitivity of 88.2%,specificity of 64.7%)and 0.770(sensitivity of 88.2%,specificity of 64.7%),*** was a significant difference in mechanical ventilation duration between the successful weaning group and the failure weaning group(8(6,13)vs.12(7.5,17.3),p=0.043).The incidence of ventilator-associated pneumonia in the successful weaning group was significantly lower than in the failed weaning group(0.2‰vs.2.3‰,p=0.001).There was a significant difference noted between these

关键词： Driving pressure Driving pressure variation rate Acute respiratory distress syndrome Mechanical ventilation

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Alcohol and illicit drugs:prevalence of alcohol and illicit drug use and their predictors in young people from Argentina,Bulgaria,Chile and Romania

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Global Health Journal 2024年第1期8卷 16-23页

作者： Daniel Vankov David Jankovszky Borislav Vankov Martin Galanternik Claudia Rodriguez Michiel de Ruyter Scientific Organization from Partium Oradea 410204Romania Queensland University of Technology BrisbaneQueensland 4001Australia Association for Youth and Students in Partium Oradea 410102Romania Community Centre Bright day-2009 Vidin 3700Bulgaria MiNU Civil.Association Buenos Aires 4918Argentina ONG No Chat Santiago 832000Chile

Background:Alcohol and illicit drugs(AID)continue to be a major global health *** preventable,AID is linked to millions of deaths annually *** situation is particularly grave for young people,with AID being a major direct risk factor for disability-adjusted youth life-years lost and *** further contributes to assaults,road crashes,accidental poisoning,and suicide,leading to long-term issues and public health ***:This study aimed at disclosing current AID prevalence data for Argentinian,Bulgarian,Chilean and Romanian *** shed light on the predictors of AID in young people from those ***:The study used an online survey to gather data from people aged 18 to 25(n=1,297).The survey was underpinned by the theory of planned behaviour(TPB).Predictors were investigated separately for drinking alcohol and using illicit ***:Our data revealed that across the four target countries,49%to 90%of the participants drank alcohol,and 8%to 35%used illicit drugs in the past three *** 20%and 91%of them intended to drink,and between 8%and 31%intended to use illicit drugs in the following three *** TPB model predicted statistically significant(Pcase of Argentina,Bulgaria,Chile and *** new knowledge of understanding substance abuse determinants and prevalence may help researchers and practitioners better meet young people's health prevention needs.

关键词： Young people Alcohol Ilicit drugs Intention Self-efficacy

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Coca-Cola consumption vs fragmentation in the management of patients with phytobezoars:A prospective randomized controlled trial

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World Journal of Gastrointestinal endoscopy 2024年第2期16卷 83-90页

作者： Fu-Guo Liu De-Feng Meng Xia Shen Dan Meng Ying Liu Ling-Yun Zhang Department of Gastroenterology The Affiliated Hospital of Qingdao UniversityQingdao 266000Shandong ProvinceChina endoscopy Center The Affiliated Hospital of Qingdao UniversityQingdao 266000Shandong ProvinceChina

BACKGROUND Gastric phytobezoars(GPBs)are very common in northern *** therapy involving carbonated beverage consumption and endoscopic lithotripsy has been shown to be effective and *** studies on this subject are often case reports highlighting the successful dissolution of phytobezoars through Coca-Cola ***,large-scale prospective investigations in this domain remain ***,we conducted a randomized controlled trial to examine the effects of Coca-Cola consumption on *** To evaluate the impact of Coca-Cola on GPBs,including the dissolution rate,medical expenses,ulcer rate,and operation *** A total of 160 consecutive patients diagnosed with GPBs were allocated into two groups(a control group and an intervention group)through computer-generated *** in the intervention group received a Coca-Cola-based regimen(Coca-Cola 2000-4000 mL per day for 7 d),while those in the control group underwent emergency *** Complete dissolution of GPBs was achieved in 100% of the patients in the intervention *** disparity in expenses between the control group and intervention group(t=25.791,P=0.000)was statistically significant,and the difference in gastric ulcer occurrence between the control group and intervention group(χ^(2)=6.181,P=0.013)was also statistically *** Timely ingestion of Coca-Cola yields significant benefits,including a complete dissolution rate of 100%,a low incidence of gastric ulcers,no need for fragmentation and reduced expenses.

关键词： Coca-Cola Bezoars Solubility Lithotripsy Gastrosco

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