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pISSN 2636-0004
eISSN 2636-0012
pISSN 2636-0004
eISSN 2636-0012
and Concetta Maria Porretto Abstract : Colon cancer is characterized during its history, by developing metastases in approximately 50% of patients. The organ most affected by this process is the liver and every year 900,000 new cases of colorectal cancer with liver metastases are recorded. In this disease setting, the therapeutic strategies include a combined treatment with loco-regional therapies and systemic chemotherapy treatments, with close collaboration between oncologists and surgeons. But the diversity of the clinical pictures that can present in patients with colorectal cancer liver metastases often makes it difficult to plan the sequence between surgery and chemotherapy, making it necessary to deal with these cases in a multidisciplinary team where the various professional figures discuss together individual cases to decide the best therapeutic strategy.
, Farnad Imani , Bahar Mahjoubi et al.Abstract : Background: Fecal incontinence (FI) results from damage to the external anal sphincter (EAS), significantly affecting quality of life. This clinical trial evaluated the impact of low-level laser (LLL) therapy on EAS repair and the treatment of FI. Methods: Thirty FI patients with EAS deficiency were divided into two groups (n = 15): a control group receiving sphincteroplasty alone and a laser group undergoing sphincteroplasty plus laser therapy. Following surgery, the laser group received daily laser therapy for 2 weeks. Outcomes were assessed using Wexner scores, electromyography (EMG), and endorectal sonography. Results: The laser group exhibited a significant increase in muscle bulk (P = 0.008) and a lower Wexner index (P < 0.0001) compared to the control group. EMG confirmed muscle contractility in the laser group. Conclusions: Two weeks of LLL therapy effectively increased muscle at the EAS injury site, leading to significant, lasting improvements in FI.
, Yunho Jung , Han Hee Lee et al.Abstract : Background: Delayed post-polypectomy bleeding (DPPB) is a serious complication of polypectomy that is poorly understood. The aim of this study was to evaluate the effectiveness of endoscopic hemostasis in managing DPPB and to identify associated risk factors. Methods: We retrospectively analyzed 289 patients who experienced DPPB (≥ 24 hours after polypectomy) and underwent endoscopic hemostasis at five university hospitals between 2005 and 2018. Patient characteristics, polyp size, technical factors, rebleeding, complications, and length of hospitalization were assessed. Results: Endoscopic hemostasis was successful in all 289 cases of DPPB. The techniques and devices employed included epinephrine injection (24.9%), argon plasma coagulation (18.0%), hemostatic forceps (10.7%), and hemoclips (87.9%). Rebleeding occurred in 15 cases (5.2%) after initial endoscopic hemostasis. The incidence of rebleeding was significantly associated with polyp size (< 10 mm: 2.8%, 10 mm–19 mm: 5.6%, ≥ 20 mm: 13.5%, P = 0.030) and sedation status (yes: 1.8%, no: 7.3%, P = 0.040). However, hemostasis method, bleeding characteristics, and polyp location were not significantly linked to rebleeding. Multivariate analysis revealed that polyp size (odds ratio, 5.02; 95% confidence interval, 1.25–20.13; P = 0.023) was significantly associated with rebleeding after endoscopic hemostasis for DPPB. In all 15 cases of rebleeding, a second endoscopic hemostasis was successfully performed without the need for embolization or surgical intervention. No perforations occurred during the first or second endoscopic hemostatic procedures.Conclusion: Polyp size and sedation status were associated with rebleeding after endoscopic hemostasis for DPPB. As an intervention for DPPB, endoscopic hemostasis appears safe and effective.
, Ashish Rasik Kale , and Kala Gnanasekaran Kiruthiga Abstract : We report a case of gallbladder cancer, which presented exclusively as tight pyloric stenosis. The patient had persistent vomiting, severe weight loss, and esophageal symptoms due to gastric reflux. Earlier, endoscopy had shown pyloric stenosis and computed tomography suggested gastric outlet obstruction. The result of endoscopic balloon dilation was poor, though a small caliber video scope could be passed over a guide wire distally into the duodenum. A positron emission tomography scan revealed a metabolically active lesion involving the pyloric canal and the patient was then subjected to surgery. Histopathology of the resected specimen identified the gallbladder cancer infiltrating the pylorus.
, Vikas Pemmada , and Parvesh Kumar Jain Abstract : Congenital anomalies of the biliary tree are rare and present challenges for endoscopists performing interventions such as endoscopic retrograde cholangiopancreatography (ERCP). The reported incidence of ectopic biliary drainage ranges from 2% to 20%, and the condition is often associated with pancreatobiliary complications, including choledocholithiasis (56%), cholangitis (39%), and acute pancreatitis (18.2%). These developmental abnormalities originate during embryogenesis. Uncommon sites for the ampullary opening include the third or fourth part of the duodenum, the stomach, and the pancreatic duct. We report a rare case of ectopic ampulla opening into the pylorus, which presented with cholangitis and was successfully managed with a modified ERCP technique.
, Mit Shah , Chintan Tailor et al.Abstract : A 21-year-old man presented with acute onset of jaundice, abdominal pain, ascites, and hepatomegaly, along with a history of Budd-Chiari syndrome previously treated with vena cava angioplasty. Investigations revealed rapidly worsening jaundice, coagulopathy, elevated creatinine levels, reactive hepatitis B serology, and positive antiphospholipid antibodies, with scores indicating a poor prognosis for liver transplant-free survival. Abdominal computed tomography demonstrated a narrowed intrahepatic vena cava and new thrombosis in the right and middle hepatic veins. Renal biopsy, prompted by nephritic range proteinuria, indicated mesangioproliferative glomerulonephritis (MPGN) with immune complex deposition. The described case involves acute-on-chronic liver failure with acute insults from new onset hepatic vein thrombosis and hepatitis B reactivation, in a patient at a non-transplant center, who also had underlying antiphospholipid antibody syndrome, and MPGN. The patient was successfully treated with antiviral, anticoagulation, and antiplatelet agents, along with a sodium-glucose cotransporter 2 inhibitor and a direct intrahepatic portosystemic shunt, despite having a Model for End-Stage Liver Disease score of 35.
, Arvind Kumar Khurana, Apoorva Batra et al.Abstract : Portal hypertension, a known complication of liver cirrhosis, typically leads to variceal bleeding in the esophagus and stomach. However, ectopic varices can also occur outside the gastroesophageal region and may present with life-threatening massive bleeding. We report a case of bleeding ileal ectopic varices in a patient with cirrhosis that were not detected during routine endoscopy. These varices were ultimately diagnosed with the aid of abdominal computed tomography. A transjugular intrahepatic portosystemic shunt (TIPS) was created to decrease portal pressure, and the TIPS tract was then used to selectively embolize the bleeding ectopic ileal varices.
Hyung Ku Chon and Seong-Hun Kim
Int J Gastrointest Interv 2023; 12(1): 7-15
https://doi.org/10.18528/ijgii220037
Se Hwan Kwon , Seung Yeon Noh , and Joo Hyeong Oh
Int J Gastrointest Interv 2023; 12(1): 37-42
https://doi.org/10.18528/ijgii220005
Nam Hee Kim and Hong Joo Kim
Int J Gastrointest Interv 2023; 12(2): 57-63
https://doi.org/10.18528/ijgii220004
Partha Mandal , Barrett P. O'Donnell , Eric Reuben Smith , Osamah Al-Bayati , Adam Khalil , Serena Jen , Mario Vela , and Jorge Lopera
Int J Gastrointest Interv 2022; 11(1): 18-23
https://doi.org/10.18528/ijgii210028
Young Koog Cheon
Int J Gastrointest Interv 2021; 10(3): 96-100
https://doi.org/10.18528/ijgii210032
Dominic Andre Staudenmann , Ellie Patricia Skacel , Tatiana Tsoutsman , Arthur John Kaffes , and Payal Saxena
Int J Gastrointest Interv 2021; 10(3): 128-132
https://doi.org/10.18528/ijgii200050
pISSN 2636-0004
eISSN 2636-0012
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