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Amir Mari, Fadi Abu Backer, Mahmud Mahamid, Hana Amara, Dan Carter, Doron Boltin, Ram Dickman
Functional abdominal bloating and distension (FABD) are common gastrointestinal complaints, encountered on a daily basis by gastroenterologists and healthcare providers. Functional abdominal bloating is a subjective sensation that is commonly associated with an objective abdominal distension. FABD may be diagnosed as a single entity (the sole or cardinal complaint) or may overlap with other functional gastrointestinal disorders such as functional constipation, irritable bowel syndrome, and functional dyspepsia...
March 16, 2019: Advances in Therapy
Talha Qureshi, T Peter Nguyen, Ruifei Wang, Diana Willis, Rajesh Shah, Jason K Hou
BACKGROUND: Anemia is a common complication of inflammatory bowel disease (IBD). Despite existing guidelines for anemia in IBD, it is frequently under-treated and the prevalence of anemia has remained high. To address this gap, the Crohn's and Colitis Foundation developed the Anemia Care Pathway (ACP). AIMS: To implement the ACP in a managed care setting and identify where it improves practice habits and where barriers remain. METHODS: The ACP was implemented from July 2016 through June 2017 and retrospectively studied...
March 16, 2019: Digestive Diseases and Sciences
Andrew D Clark, Mateusz Hasso-Agopsowicz, Matthew W Kraus, Lisa K Stockdale, Colin F B Sanderson, Umesh D Parashar, Jacqueline E Tate
BACKGROUND: In some countries that have introduced oral rotavirus vaccines, a small but elevated risk of intussusception-a rare bowel disorder-has been reported. Updated estimates on the global epidemiology of intussusception are needed to help predict the potential number of intussusception cases that could be caused by the vaccine in different settings. METHODS: We estimated incidence rates, age distributions and case-fatality ratios (CFRs) for intussusception hospital admissions among children aged <5 years, before the introduction of rotavirus vaccines...
March 16, 2019: International Journal of Epidemiology
Michael R Mallmann, Heiko Reutter, Ingo Gottschalk, Annegret Geipel, Christoph Berg, Ulrich Gembruch
BACKGROUND: Enterolithiasis is a sonographic sign defined by hyperechogenic foci within the - often distended - fetal bowel. OBJECTIVES: We report on a series of 20 cases with enterolithiasis diagnosed prenatally and illustrate the spectrum of associated malformations. METHOD: This was a retrospective study involving 20 fetuses with enterolithiasis at two large tertiary referral centers in Germany over a 17-year period (2000-2017). RESULTS: Median diagnosis was made with ultrasound at 18+2 weeks of gestation (IQR25,75: 14+5, 26+5)...
March 15, 2019: Fetal Diagnosis and Therapy
Richard Fagan, Syed Sabeeh Najam Bokhari, Faisal Inayat
Carcinoid tumours have the ability to secrete various peptides and bioamines that lead to carcinoid syndrome manifested as cutaneous flushing, diarrhoea, bronchial constriction and cardiac involvement. The deficiencies of vitamins D and B12 have previously been reported in patients with carcinoid tumours presumably due to chronic diarrhoea associated with the carcinoid syndrome. Herein, we chronicle the case of a patient with opioid use disorder who presented with small bowel obstruction that was found to be caused by a midgut carcinoid tumour...
March 16, 2019: BMJ Case Reports
Yonah B Esterson, Marian Gaballah, Gregory M Grimaldi, Micheal H Raj, John S Pellerito
Dermoid cysts, or mature cystic teratomas, are complicated by malignant degeneration in only 1-2% of cases. Rarely, dermoid cysts result in complications of small bowel obstruction or entero-ovarian fistula formation. In the current report we present the case of a 59-year-old female with a known dermoid cyst who presented with leukocytosis and was discovered to have a small bowel obstruction at the level of an ileo-ovarian fistula. The patient was taken to the operating room and was treated with total abdominal hysterectomy, bilateral salpingo-oopherectomy, and short segment small bowel resection...
March 8, 2019: Clinical Imaging
Ryan S Dolan, Daryl Goldman, Mark El-Deiry, Nima Kokabi, Zachary L Bercu, Janice Newsome, Jonathan G Martin
RATIONALE AND OBJECTIVES: Requests for gastrostomy tube placement in patients on aspirin (ASA) 325 mg are common, particularly in patients following reconstructive surgery for head and neck cancer, but periprocedural guidelines and recommendations regarding management of high dose aspirin are inconsistent. The purpose of this study was to assess the bleeding risk of percutaneous gastrostomy tube placement in patients on ASA 325 mg. MATERIALS AND METHODS: This retrospective study of 213 patients who underwent image-guided "push" percutaneous gastrostomy tube placement compared rates of significant bleeding and other secondary outcomes (including all-cause mortality within 30 days, procedure-related mortality, bowel perforation, abdominal abscess, peritonitis, aspiration pneumonia, intraprocedural airway complications, and tube dislodgement) between patients maintained on ASA 325 mg and patients not on antiplatelet or anticoagulation therapy...
March 14, 2019: Academic Radiology
Laura Setyo, Shannon L Donahoe, Jan Šlapeta
Tritrichomonas foetus is a flagellate protist which commonly causes a waxing and waning large bowel diarrhoea in young cats. We report severe T. foetus infection of the colon, cecum and ileum with concurrent feline enteric coronavirus (FCoV) and feline panleukopenia virus (FPV) in a 3-month-old Bengal kitten with an 8-day history of vomiting, diarrhoea, failure to thrive and coughing. Protozoa filling the lumen and crypts and occasional invading into lamina propria were identified within the affected colon and confirmed by PCR as T...
March 2019: Veterinary Parasitology
Malek A Al-Omari, Mohammad A Al-Doud
INTRODUCTION: Intestinal obstruction ascribed to internal hernia is quite rare, especially in adults. There are no differentiating features in the presentation of intestinal obstruction due to internal hernia as compared to other causes. Delay in the diagnosis of this condition carries a considerable risk especially in a virgin abdomen. We report a rare case of internal hernia which presented as acute small and large bowel obstruction. PRESENTED CASE: We report a 47- year- old male with generalized abdominal pain associated with vomiting and obstipation...
February 27, 2019: International Journal of Surgery Case Reports
Anna M Buchner
Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, can be effectively monitored with the use of endoscopy. The additional application of small field imaging technology such as confocal laser endomicroscopy CLE during ongoing endoscopic evaluation has led to real-time visualization of mucosal abnormalities and thus in vivo histology. The endomicroscopy (CLE) can improve IBD endoscopic evaluation by identifying seemingly normal-appearing mucosa, assessing the function of the intestinal barrier of the epithelium and vascular permeability, and by characterizing any mucosal lesions, including dysplastic lesions...
March 16, 2019: Inflammatory Bowel Diseases
Jimmy K Limdi, Jennifer Farraye, Rachel Cannon, Elisabeth Woodhams, Francis A Farraye
The peak incidence of the inflammatory bowel diseases (IBDs) is between the second and fourth decades of life, which coincides with prime reproductive years. Unplanned or mistimed pregnancies may account for nearly half of all pregnancies and are associated with adverse consequences such as a higher risk of delayed preconceptual care, increased risk of preterm birth, low birth weight, and adverse maternal and neonatal outcomes. Increased IBD activity during pregnancy is also associated with adverse pregnancy-related outcomes, such as miscarriage, intrauterine growth retardation, and preterm birth...
March 16, 2019: Inflammatory Bowel Diseases
Diane Mege, Alice Frontali, Gianluca Pellino, Samuel Adegbola, Léon Maggiori, Janindra Warusavitarne, Yves Panis
BACKGROUND: There is no consensus about the most appropriate management of rectal stump in laparoscopic subtotal colectomy (STC) performed for inflammatory bowel disease (IBD). The objective is to report our experience of laparoscopic STC with double-end ileosigmoidostomy in the right iliac fossa for IBD. METHODS: All patients undergoing laparoscopic STC and double-end ileosigmoidostomy in the right iliac fossa for IBD in 2 European expert centres were included...
March 14, 2019: Surgical Endoscopy
Sang Won Kim, Hyun Cheol Kim, Jiyoung Oh, Kyu Yeoun Won, Seong Jin Park, Dal Mo Yang
Since a broad spectrum of tumors can occur in the small bowels, it is not easy to make a correct differential diagnosis among small bowel tumors on CT findings. Therefore, once a mass is detected on CT, the radiologist needs to analyze the mass based on presenting patterns such as location, multiplicity, morphology, and enhancement patterns. In this article, we will illustrate various kinds of small bowel tumors based on imaging patterns at CT to facilitate making a correct diagnosis.
March 14, 2019: Abdominal Radiology
Alka A Potdar, Dalin Li, Talin Haritunians, Kelli L VanDussen, Marie F Fiorino, Ta-Chiang Liu, Thaddeus S Stappenbeck, Phillip Fleshner, Stephan R Targan, Dermot P B McGovern, Janine Bilsborough
BACKGROUND AND AIMS: Heterogeneity in Crohn's disease (CD) provides a challenge for development of effective therapies. Our goal was to define a unique molecular signature for severe, refractory CD to enable precision therapy approaches to disease treatment and facilitate earlier intervention in complicated disease. METHODS: We analyzed clinical meta-data, genetics and transcriptomics from uninvolved ileal tissue from CD patients that underwent a single SB resection...
March 16, 2019: Journal of Crohn's & Colitis
Patricia A Huerta, Manuel Cifuentes, Charles Levenstein, David Kriebel
BACKGROUND: Irritable bowel syndrome (IBS) is a stress-related disease linked to psychosocial factors, though knowledge about its occupational psychosocial aspects is scarce. OBJECTIVE: A cross-sectional study of the prevalence of IBS and its association with occupational psychosocial factors in Chilean workers was conducted. METHODS: IBS prevalence, using the IBS-Rome IV criteria, in the working population was estimated using data from the National Health Survey of 2009...
March 16, 2019: Annals of Work Exposures and Health
Kazuhiko Uchiyama, Yuji Naito, Tomohisa Takagi
Recently, the pathogenesis of systemic inflammatory disease such as inflammatory bowel disease (IBD), multiple sclerosis (MS), systemic inflammatory arthritis, asthma, and non-alcoholic fatty liver disease has been reported to be related to the dysbiosis of gut microbiota. The contribution of special bacteria for the development of those diseases has been elucidated by disease animal models such as germ-free mice. Besides, the contribution by several bacteria for the pathogenesis of those diseases has been suggested by detailed analysis of the 16 small ribosomal subunit RNA (16S rRNA) from stool samples of the patients...
March 12, 2019: Pharmacology & Therapeutics
Siddharth Singh, Antonio Facciorusso, Parambir S Dulai, Vipul Jairath, William J Sandborn
BACKGROUND & AIMS: We performed a systematic review and meta-analysis to evaluate the comparative risk of serious infections with tumor necrosis factor (TNF) antagonists, non-TNF targeted biologics, tofacitinib, and immunosuppressive agents in patients with inflammatory bowel diseases (IBD). METHODS: In a systematic search of publications, through March 18, 2018, we identified 15 observational studies (>500 person-years) of patients with IBD treated with TNF antagonists, non-TNF targeted biologics, tofacitinib, and/or immunosuppressive agents (thiopurines, methotrexate) that reported risk of serious infections...
March 12, 2019: Clinical Gastroenterology and Hepatology
Tomas Castro-Dopico, Thomas W Dennison, John R Ferdinand, Rebeccah J Mathews, Aaron Fleming, Dean Clift, Benjamin J Stewart, Chenzhi Jing, Konstantina Strongili, Larisa I Labzin, Edward J M Monk, Kourosh Saeb-Parsy, Clare E Bryant, Simon Clare, Miles Parkes, Menna R Clatworthy
Inflammatory bowel disease is a chronic, relapsing condition with two subtypes, Crohn's disease (CD) and ulcerative colitis (UC). Genome-wide association studies (GWASs) in UC implicate a FCGR2A variant that alters the binding affinity of the antibody receptor it encodes, FcγRIIA, for immunoglobulin G (IgG). Here, we aimed to understand the mechanisms whereby changes in FcγRIIA affinity would affect inflammation in an IgA-dominated organ. We found a profound induction of anti-commensal IgG and a concomitant increase in activating FcγR signaling in the colonic mucosa of UC patients...
February 27, 2019: Immunity
Takafumi Kawano, Oliver J Muensterer
Reducing the herniated viscera such as the spleen, the liver, and the bowel in thoracoscopic repair of congenital diaphragmatic hernia can be challenging. The small instruments involved can easily create damage, particularly to the friable capsule of the solid organs involved. We herein demonstrate a new gentle method of reducing the diaphragmatic hernia using sequential twisting of the sac. The patient was a 3 day old girl with left sided Bochdalek diaphragmatic hernia. Chest X-ray showed intestinal herniation into the thoracic cavity, and we planned to perform elective Minimal-invasive surgery...
March 6, 2019: International Journal of Surgery Case Reports
Vincenzo Pilone, Mafalda Romano, Michele Renzulli, Carmen Cutolo, Salvatore Tramontano
BACKGROUND: Obesity is showing a constant increase worldwide, making it the major public health problem. Bariatric surgery seems to be the best treatment for these to achieve a good excess weight loss. Gastric by-pass (GBP) is one the most important bariatric procedure, but there are a lot of complications as bowel obstruction for internal hernia, fistula and intussusception. CASE REPORT: We present a peculiar case report of a 53-years old woman that underwent to GBP...
March 5, 2019: International Journal of Surgery Case Reports
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