Maintenance treatment with fluoropyrimidine plus bevacizumab versus fluoropyrimidine alone after induction chemotherapy for metastatic colorectal cancer: The BEVAMAINT - PRODIGE 71 - (FFCD 1710) phase III study
Maintenance treatments with fluoropyrimidine alone or combined with bevacizumab after induction chemotherapy are two standard options in first-line metastatic colorectal cancer (mCRC). However, no trial has compared these two maintenance regimens. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 31, 2020 Category: Gastroenterology Authors: Manfredi Sylvain, Turpin Anthony, Malka David, Barbier Emilie, Laurent-Puig Pierre, Zaanan Aziz, Dahan Laeticia, Li èvre Astrid, Phelip Jean-Marc, Michel Pierre, Hautefeuille Vincent, Legoux Jean-Louis, Lepage Côme, Tougeron David, Aparicio Thomas Tags: Progress Report Source Type: research

Endoscopic removal of a needle in the pancreatic head
A 31 year-old-man presented with a 1-week history of persistent upper abdominal pain. Physical examination showed tenderness at the epigastric area, without rebound tenderness. A computed tomography scan of the abdomen showed antrum irregular thicken and a needle-type radiopaque foreign body penetrated into the pancreatic head (A). We presumed that this patient ingested a needle that penetrated the gastric antrum and migrated into the pancreatic body. We attempted to extract the foreign body endoscopically to avoid undergoing a laparotomy. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 31, 2020 Category: Gastroenterology Authors: Jinpei Dong, Dapeng Bian, Qiushi Feng Tags: Image of the Month Source Type: research

Extraintestinal manifestation of inflammatory bowel disease in Asian patients: A multinational study
Although inflammatory bowel disease (IBD) incidence has increased over the past two decades in Asia, data on extraintestinal manifestations (EIMs) of IBD in Asian patients are limited. We aimed to evaluate the prevalence and clinical characteristics of EIMs in Asian IBD patients. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 29, 2020 Category: Gastroenterology Authors: Soo-Kyung Park, Zhiqin Wong, Sang Hyoung Park, Khien Van Vu, Ki Bae Bang, Panida Piyachaturawat, Thein Myint, Ida Hilmi, Dong-Il Park Tags: Alimentary Tract Source Type: research

Effect of poorly absorbable antibiotics on hepatic venous pressure gradient in cirrhosis: A systematic review and meta-analysis
The effects of poorly/non-absorbable antibiotics on hepatic venous pressure gradient (HVPG) are debated. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 28, 2020 Category: Gastroenterology Authors: Yuly P. Mendoza, Susana G. Rodrigues, Jaime Bosch, Annalisa Berzigotti Tags: Meta-Analysis Source Type: research

Patients with chronic hepatitis C receiving treatment with direct acting antivirals: How is this population changing?
Direct acting antiviral agents (DAAs) have revolutionized the landscape of chronic hepatitis C (CHC) enabling treatment of all those infected. It remains to be determined how the characteristics of those receiving treatment are changing. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 27, 2020 Category: Gastroenterology Authors: Andrea Lombardi, Marta Colaneri, Kesav Aditya Vijayagopal, Margherita Sambo, Patrizia Legnazzi, Paolo Sacchi, Valentina Zuccaro, Laura Maiocchi, Renato Maserati, Roberto Gulminetti, Layla Pagnucco, Stefano Novati, Domenico Zanaboni, Giuseppe Michelone, Se Tags: Liver, Pancreas and Biliary Tract Source Type: research

Reply to comment: Screening for active COVID-19 infection prior to biologic therapy in IBD patients: primum non n ŏcēre
We have read with interest the comments to our article [1] written by Festa et al “Screening for active COVID-19 infection prior to biologic therapy in IBD patients: let's not increase our uncertainty without reducing our concerns [2]” recently published on Digestive and Liver Disease. The authors criticized our suggestion to expand the screening commonly recommended prior to the beginning of biologic therapy in Inflammatory Bowel Disease (IBD) patients, to include SARS-CoV-2 RT-PCR and, when available, antibody testing. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 27, 2020 Category: Gastroenterology Authors: Fabiana Zingone, Andrea Buda, Edoardo Savarino Source Type: research

Safe administration of corticosteroids in severe ulcerative colitis and active SARS-CoV2 infection
SARS-CoV2 is a novel coronavirus responsible for a potentially life-threatening infectious disease named COVID-19. Currently, there is no effective treatment for SARS-CoV2, and COVID-19 is managed with symptomatic therapies and supportive care. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 27, 2020 Category: Gastroenterology Authors: Pierre Mayer, Antonio Saviano, Lo ïc Kassegne, Thomas F. Baumert, Jean-Marie Reimund, François Habersetzer Source Type: research

Stimulatory effect of gastroesophageal reflux disease (GERD) on pulmonary fibroblast differentiation
Epidemiological studies indicate that prolonged micro-aspiration of gastric fluid is associated in gastroesophageal reflux disease with the development of chronic respiratory diseases, possibly caused by inflammation-related immunomodulation. Therefore, we sought to ascertain the effect of gastric fluid exposure on pulmonary residential cells. The expression of α-smooth muscle actin as a fibrotic marker was increased in both normal human pulmonary fibroblast cells and mouse macrophages. Gastric fluid enhanced the proliferation and migration of HFL-1 cells and stimulated the expression of inflammatory cytokines in an ...
Source: Digestive and Liver Disease - July 26, 2020 Category: Gastroenterology Authors: Cheng Che Chiang, Chin-Ming Chen, Jau Ling Suen, Hsiang Han Su, Chong Chao Hsieh, Chih-Mei Cheng Tags: Alimentary Tract Source Type: research

When nature tries to find its way: An unusual case of choledocho-duodenal fistula complicating a difficult choledocholithiasis
An 88 year-old male was admitted for fever, leukocytosis and abnormal cholestasis. Abdominal ultrasound showed dilation of biliary intra-hepatic ducts and common bile duct (CBD) with 2 cm stone inside. The patient was scheduled for ERCP. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 25, 2020 Category: Gastroenterology Authors: Roberto Di Mitri, Daniela Scimeca, Ambra Bonaccorso, Filippo Mocciaro Tags: Image of the Month Source Type: research

A further step forward in our knowledge of the pathogenetic role of gastroesophageal reflux in pulmonary fibrosis
Pulmonary fibrosis is a repair response in lung tissue injury that involves loss of epithelial cells and accumulation of fibroblasts/myofibroblasts [1]. The main triggers of this fibrotic progression might be viral infections, organic and inorganic dusts, smoking and Gastroesophageal Reflux Disease (GERD). Furthermore, the majority of published studies have suggested that there is a strong comorbidity between GERD and Idiopathic pulmonary fibrosis (IPF) [2,3]. Based on this knowledge, we have read with interest the paper entitled “Stimulatory Effect of Gastroesophageal Reflux Disease (GERD) on Pulmonary Fibroblast Di...
Source: Digestive and Liver Disease - July 25, 2020 Category: Gastroenterology Authors: Pelin Erg ün, Vincenzo Savarino Tags: Commentary Source Type: research

Digestive and Liver Diseases and the COVID-19 Pandemic
Coronavirus disease 2019 (COVID-19) is caused by the highly contagious zoonotic coronavirus SARS-CoV-2. The first cases of the disease were reported in China in December 2019; in the following months, the infection spread across the world, and by March 2020, it had been declared a global pandemic by the World Health Organization. To contain the spread of the infection, emergency measures, ranging from various degrees of social distancing to complete lockdowns have been adopted in different countries at different times. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 24, 2020 Category: Gastroenterology Authors: Roberto de Franchis Tags: EDITORIAL Source Type: research

Editorial Board
(Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 24, 2020 Category: Gastroenterology Source Type: research

Synchronous duodenal and colonic advanced adenomas during post-colorectal cancer surveillance
A 78-year-old man with a sigmoidectomy history for pT2N0M0 colon adenocarcinoma presented with elevated carcinoembryonic antigen. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) was performed for comprehensive evaluation which indicated multiple high FDG uptake lesions suspicious for malignancy (Fig.  1). Subsequent esophagogastroduodenoscopy (EGD) and colonoscopy respectively revealed a 30-mm semipedunculated polypoid lesion in the duodenum and an 8-mm sessile polyp in the ascending colon (Fig. 2) but without the sign of anastomotic recurrence. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 23, 2020 Category: Gastroenterology Authors: Tao Dong, Lan Wang, Lili Zhao, Zhining Fan Tags: Image of the Month Source Type: research

“Shedding light on painless chronic pancreatitis”
Chronic pancreatitis (CP) is characterized by a progressive inflammation leading to atrophy, fibrosis, calcification and ductal strictures of the pancreas. A long-lasting CP will result in exocrine and endocrine insufficiency. Well-known etiological risk factors comprise nutritive/toxic, genetic, environmental and autoimmune causes [1]. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 22, 2020 Category: Gastroenterology Authors: Marcus Hollenbach, Luca Barresi Tags: Commentary Source Type: research

Will “Video kill the Radiostar” or is zooming just a pandemic transient Hype? Some cautionary notes
Throughout these last 3 months, many Gastroenterologists have been facing the thrills of substantial video conferencing, watching webinars, conference calls, discussing new strategies and solutions while struggling not only with these challenging times but, unexpectedly for them, with bandwidth and video resolution issues. We all acknowledge the extreme usefulness of this tool, during times of uncertainty and when prompt sharing of information and cross talking is seriously needed. But after some weeks, surprisingly, we also recognized that the amount of time spent with these virtual meetings -chats, seminars and so on, - ...
Source: Digestive and Liver Disease - July 21, 2020 Category: Gastroenterology Authors: Guilherme Macedo Tags: Correspondence Source Type: research

How endoscopy centers prepare to reopen after the acute COVID-19 pandemic interruption of activity
During the recent outbreak of COV-SARS 2 infection, most hospitals in Italy as well as in almost every country of the world have been forced to reallocate their resources to cope with the huge flow of patients in need of hospitalization and even intensive care for respiratory symptoms. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 21, 2020 Category: Gastroenterology Authors: V Castagna, E Armellini, F Pace, Fast Track Endoscopy Study Group, C Alvisi, S Agazzi, A Amato, L Dioscoridi, E Filippi, C Gemme, V Imbesi, G Manes, M Mutignani, S Orlando, R Penagini, F Radaelli, R Reati, M Schettino, D Stradella, G Venezia, C Verna Tags: Correspondence Source Type: research

Application of EASL 2017 criteria for switching hepatitis B patients from tenofovir disoproxil to entecavir or tenofovir alafenamide
To overcome safety limitations of tenofovir-disoproxil, EASL guidelines proposed switching chronic hepatitis B patients older than 60 years or with bone or renal disease to tenofovir-alafenamide or entecavir. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 20, 2020 Category: Gastroenterology Authors: Luisa Roade, Alessandro Loglio, Marta Borghi, Mar Riveiro-Barciela, Roberta Soffredini, Floriana Facchetti, Dhanai di Paolo, David Tabernero, Giovanna Lunghi, Rafael Esteban, Maria Buti, Pietro Lampertico Tags: Original Article Source Type: research

Noninvasive monitoring of inflammatory bowel disease in the post covid-19 era
LETTER TO THE EDITOR (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 19, 2020 Category: Gastroenterology Authors: Olga Maria Nardone, Antonio Rispo, Fabiana Castiglione Tags: Correspondence Source Type: research

Children and Fecal SARS-CoV-2 shedding: Just the tip of the Iceberg of Italian COVID-19 outbreak?
As of June 18, 2020, 8061,550 cases of infection by the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) known to cause Coronavirus disease 2019 (COVID-19) were reported worldwide with 440,290 deaths [1]. Italy was one of the first affected countries, experiencing a particularly high incidence and case fatality rate (CFR). Totally, 237,695 documented infections have been reported in Italy, with the Northern Regions accounting for almost two-thirds of cases [2]. Age distribution shows that only 2.2% of cases affected children ( (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 18, 2020 Category: Gastroenterology Authors: Salvatore Oliva, Salvatore Cucchiara, Franco Locatelli Tags: Alimentary Tract Source Type: research

Successful treatment of gallstone ileus with double-balloon enteroscopy-assisted electrohydraulic lithotripsy
A 79-year-old male presented with a two-day history of obstipation and vomiting. An abdominal computed tomography (CT) demonstrated a small bowel obstruction with a 3.5  cm gallstone impacted in the mid-small bowel (Fig. 1A, arrow). The small bowel obstruction did not improve after three days of nasogastric tube decompression, therefore we performed double-balloon enteroscopy (DBE)-assisted electrohydraulic lithotripsy (EHL) for removal of the impacted stone. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 17, 2020 Category: Gastroenterology Authors: Satoko Kako, Yugo Iwaya, Tadanobu Nagaya, Takeji Umemura Tags: Image of the Month Source Type: research

Signet-ring cell carcinoma of the colon presenting as diffuse ulcerating polyposis in the upper and lower GI tract
A 75-year-old male patient presented with non-bloody diarrhea, nausea and vomiting since two weeks and reported weight loss of ten kilograms within the last month. Laboratory analysis showed mild normocytic anemia, slightly elevated C reactive protein and an elevated stool calprotectin. Microbiological tests were negative for viral and bacterial enteric pathogens. Upper GI endoscopy revealed innumerable, partly ulcerated polyps with a maximal size of 1  cm in all sections of the stomach (A) as well as in the duodenum. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 17, 2020 Category: Gastroenterology Authors: Andreas Blesl, Lukas Binder, Cord Langner, Christoph H ögenauer Tags: Image of the Month Source Type: research

The growing global interest in the gluten free diet as reflected by Google searches
We read with interest the article by Trovato et al. [1]. In this article, tweets for celiac disease (CD) were noted to be less common than several other conditions, such as cancer. However, ‘gluten’ and ‘free’ were the most commonly co-cited words with celiac disease. In addition to social media, we believe that other online platforms are a key information source for patients. We sought to assess the popularity of Google searches for ‘gluten-free diet’. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 16, 2020 Category: Gastroenterology Authors: A. Rej, F.W.D. Tai, P.H.R. Green, B. Lebwohl, D.S. Sanders Tags: Correspondence Source Type: research

Apple-bite colon in a child
A 10 year old girl presented with frequent painless bleeding per rectum and moderate splenomegaly for 18 months. There was no history of variceal bleeding. Systemic examination was normal. Hemogram was suggestive of hypersplenism (hemoglobin: 9.7 g%, total leucocyte count 4000/mm3, platelet count 85,000/mm3) with normal liver function tests. Colonoscopy showed large deep punched out discrete ulcers with everted edges and white exudates (Fig 1A, B) in rectosigmoid and normal areas in the rest of the colon. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 16, 2020 Category: Gastroenterology Authors: Moinak Sen Sarma, Surender Kumar Yachha Tags: Image of the Month Source Type: research

Gastric neoplasm: Gastrointestinal stromal tumor mimicking gastric carcinoma
A 69-year-old woman presented with intermittent epigastric pain for 6 months. No special family or personal history was reported. Blood tests displayed moderate anemia (hemoglobin, 75  g/L). Computed tomography (CT) showed an irregularand heterogeneously enhanced lesion at the lesser curvature of stomach and multiple enlarged lymph nodes around the stomach (Fig. 1). Endoscopy confirmed that thelesion was a hugenodular neoplasm from the cardia to the angular notch, with deep ulce ration (Fig. 2). The patient received surgical resection of the neoplasmwith regional lymph node dissection. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 15, 2020 Category: Gastroenterology Authors: Yan Li, Liansong Ye, Bing Hu Tags: Image of the Month Source Type: research

Trends in cirrhosis hospitalizations during the COVID-19 pandemic
The emergence of the COVID-19 pandemic, which started in Wuhan in 2019 changed the world and created several challenges to healthcare services. In preparation for expected increased numbers of patients with severe respiratory failure, many hospitals across the globe have intentionally reduced non-emergent procedures and hospitalizations to assure that initially scarce personal protective equipment was available and to preserve the different levels of hospital capacity. During this period, some studies reported reduced numbers of hospital admissions across different areas -from cirrhosis to heart failure [1 –4]. (Sour...
Source: Digestive and Liver Disease - July 15, 2020 Category: Gastroenterology Authors: R. Gaspar, R. Liberal, Catarina Castelo Branco, G. Macedo Tags: Correspondence Source Type: research

Prevalence of functional gastrointestinal disorders in children with celiac disease during the COVID-19 lockdown
Since December 2019, the whole world has been affected by the infection caused by the new coronavirus SARS-CoV2, which has had profound consequences for public health and the economy, but above all has left a deep mark on the peoples' minds [1]. There is still no clear evidence on how the lockdown may have affected the quality of life of patients with chronic diseases, especially in children, and if this condition may have influenced the course of multifactorial pathologies in which the mental, as well as the organic component, could play an important role [2,3]. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 14, 2020 Category: Gastroenterology Authors: Francesca Fiori Nastro, Carlo Tolone, Maria Rosaria Serra, Daniela Pacella, Angelo Campanozzi, Caterina Strisciuglio Tags: Correspondence Source Type: research

Differential diagnosis of pancreatic cysts: A prospective study on the role of intra-cystic glucose concentration
The accuracy and costs of current diagnostic methods in the differential diagnosis of pancreatic cystic lesions still has ample room for improvement. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 13, 2020 Category: Gastroenterology Authors: Davide Giuseppe Ribaldone, Mauro Bruno, Silvia Gaia, Alessandro Cantamessa, Alberto Bragoni, Paola Caropreso, Marco Sacco, Sharmila Fagoonee, Giorgio Maria Saracco, Claudio De Angelis Tags: Liver, Pancreas and Biliary Tract Source Type: research

Disseminated melanoma as the final diagnosis of a gastric lesion
Informed consent was not required. Patient was deceased and is unidentifiable by clinical information and/or provided images. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 11, 2020 Category: Gastroenterology Authors: Marisa Linhares, Fl ávio Pereira, Ana Caldeira, Rui Sousa Tags: Image of the Month Source Type: research

SARS-CoV-2 infection in severe pediatric Crohn's disease. What about anti-tumor necrosis factor α therapy?
We report the case of a 17 years-old female patient, affected by COVID-19 and under anti-TNF α treatment with adalimumab for severe Crohn's disease. She was diagnosed 10 years ago with a severe ileal and perianal complex (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 11, 2020 Category: Gastroenterology Authors: Bardasi Giulia, Alvisi Patrizia Tags: Correspondence Source Type: research

Assessing the Impact of COVID-19 on the management of patients with liver diseases: A national survey by the Italian Association for the Study of the Liver
The COVID-19 pandemic had a huge impact on national and regional health systems. The impact of SARS-CoV-2 on the quality of care for patients with liver disease is still unknown. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 10, 2020 Category: Gastroenterology Authors: Alessio Aghemo, Mario Masarone, Sara Montagnese, Salvatore Petta, Francesca Romana Ponziani, Francesco Paolo Russo, Associazione Italiana Studio Fegato (AISF) Tags: Liver, Pancreas and Biliary Tract Source Type: research

Reorganization of the Functional Gastrointestinal Disorders Unit during the SARS-CoV-2 Outbreak - Practical Recommendations
on March 11, 2020 the World Health Organization (WHO) declared Coronavirus disease 2019 (COVID-19) a pandemic.1 Worldwide, clinicians of all specialties started to deal with severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) and most of the efforts have been focused on the fight against this enemy. However, other diseases have not stopped to affect our patients and we confronted with the difficulties to provide the best care to patients with gastrointestinal diseases during this pandemic. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 10, 2020 Category: Gastroenterology Authors: Matteo Ghisa, Brigida Barberio, Greta Lorenzon, Fabiana Zingone, Edoardo Savarino Tags: Correspondence Source Type: research

Early rebleeding increases mortality of variecal bleeders on secondary prophylaxis with β-blockers and ligation
Despite secondary-prophylaxis with β-blockers and endoscopic-variceal-ligation rebleeding is frequent, particularly within the first-6-weeks. Early-rebleeding may have greater impact on death-risk than late rebleeding, which may affect therapy. We assessed whether the influence of rebleeding on long-term survival of patients on seco ndary-prophylaxis is greater in patients with early-rebleeding. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 8, 2020 Category: Gastroenterology Authors: Alba Ardevol, Edilmar Alvarado, Marta Garcia-Guix, Anna Brujats, Laura Gonzalez, Virginia Hern ández-Gea, Carles Aracil, Oana Pavel, Berta Cuyas, Isabel Graupera, Alan Colomo, Maria Poca, Xavier Torras, Mar Concepción, Càndid Villanueva Tags: Liver, Pancreas and Biliary Tract Source Type: research

Recurrent pyogenic granuloma successfully treated with endoscopic submucosal dissection four months after endoscopic mucosal resection
This report describes a case of recurrence of colonic PG after EMR successfully treated with endoscopic submucosal dissection (ESD). (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 7, 2020 Category: Gastroenterology Authors: Yuzuru Tamaru, Toshio Kuwai, Ryusaku Kusunoki, Hiroshi Kohno Tags: Image of the Month Source Type: research

A wandering SPLEEN
A 34-year-old woman was referred to us for splenomegaly. She reported several episodes of precedent acute abdominal pain in the left flank. A computed tomography (CT) was performed, showing an enlarged “wandering spleen” located in the left flank (Fig. 1A), as well as a splenic vein stenosis complicated by segmental portal hypertension (Fig. 1B). There was no abnormality in the enhancement of the spleen during the CT. The gastroscopy performed in hepato-gastroenterology did not reveal any endo scopic sign of portal hypertension. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 6, 2020 Category: Gastroenterology Authors: J-A. LEBEUL, C. OLLENDE, L. VALBOUSQUET, C. PRIEUX-KLOTZ Tags: Image of the Month Source Type: research

Unchanged surgical management of patients with Cholangiocarcinoma during the COVID-19 pandemic
In the first months of 2020 the world faced a viral respiratory disease outbreak related to coronavirus SARS-CoV-2, which was declared a pandemic by the World Health Organization (WHO) on March 31st. To date nearly 4 million cases have been documented and a quarter of a million deaths reported globally. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 6, 2020 Category: Gastroenterology Authors: Enrico Gringeri, Martina Gambato, Alessandro Furlanetto, Mattia Ballo, Eleonora Nieddu, Umberto Cillo Tags: Correspondence Source Type: research

Asymptomatic Colonic Anisakiasis
A 52 year-old woman, native of the Philippines, presented to our institution to undergo screening colonoscopy. No significant clinical history or symptoms were reported. Colonoscopy showed a 10-mm mobile gray-greenish worm (Fig. 1) in the proximal ascending colon. No mucosal injury was observed. The larva was removed with a biopsy forceps (Fig. 2) and characterized as Anisakis simplex on parasitological examination. Anamnesis confirmed usual consumption of raw fish. All laboratory tests were normal and no pathological findings were observed on the abdominal ultrasound suggesting a indolent-type anisakiasis. (Source: Digest...
Source: Digestive and Liver Disease - July 6, 2020 Category: Gastroenterology Authors: Fabio De Vincentis, Alessandra Caponi, Alessandro Mussetto, Omero Triossi Tags: Image of the Month Source Type: research

Expression of DCP1a in gastric cancer and its biological function and mechanism in chemotherapy resistance in gastric cancer cells
To detect the role of DCP1a in gastric cancer. To estimate the effect of DCP1a in gastric cancer cells on proliferation, invasion, migration and anti-drug behavior in vitro by down-regulating its expression. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 6, 2020 Category: Gastroenterology Authors: Tuo Ruan, Yazhi Zhang, Weizhen Liu, Yuan Li, Dianshi Wang, Zhouyuan Du, Kaixiong Tao, Chuanqing Wu Tags: Oncology Source Type: research

Multidrug regimens for treatment of older patients with metastatic pancreatic cancer
Older patients with metastatic pancreatic adenocarcinoma (MPDAC) are under-represented in clinical trials. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 3, 2020 Category: Gastroenterology Authors: Marina Macchini, Marta Chiaravalli, Chiara Pircher, Silvia Zanon, Umberto Peretti, Elena Mazza, Maria Maddalena Valente, Clara Fugazza, Luca Gianni, Michele Reni Tags: Oncology Source Type: research

Delays in colonoscopy start time are associated with reductions in adenoma detection rates
Prior investigations of the impact of case delays on adenoma detection rates have not found a significant association, though these studies included modest delays, with few cases delayed by more than one hour. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 2, 2020 Category: Gastroenterology Authors: Monika Laszkowska, Srihari Mahadev, Chin Hur, Peter H.R. Green, Benjamin Lebwohl Tags: Digestive Endoscopy Source Type: research

Patients with COVID-19 present with low plasma citrulline concentrations that associate with systemic inflammation and gastrointestinal symptoms
While gastrointestinal symptoms are more and more recognized, the exact etiopathogenesis of SARS-CoV-2-associated diarrhea is still unknown [1]. It also remains unclear whether SARS-CoV-2 directly impacts enterocytes. The amino acid citrulline is not incorporated into proteins and is involved in intermediary metabolism. In humans, plasma citrulline is almost exclusively produced by enterocytes. Therefore, citrulline is used as a biomarker of small bowel enterocyte mass and function. For example, it is decreased in total villous atrophy as well as in short bowel syndrome with generally accepted thresholds of 10 μmol/L an...
Source: Digestive and Liver Disease - July 2, 2020 Category: Gastroenterology Authors: Mathieu Uzzan, Damien Soudan, Katell Peoch, Emmanuel Weiss, Olivier Corcos, Xavier Treton Source Type: research

Magnetic resonance imaging assessment of body composition parameters in Crohn's disease
Body composition, currently evaluated by computed tomography scan, is related to poor evolution and severity of Crohn's disease (CD). Few MRI studies have been performed, yet it is the most commonly used imaging modality for the surveillance of the disease. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - July 1, 2020 Category: Gastroenterology Authors: Ghislain Labarthe, Michael Dolores, Mikael Verdalle-Cazes, Clo é Charpentier, Pauline Roullee, Jean-Nicolas Dacher, Guillaume Savoye, Céline Savoye-Collet Tags: Alimentary Tract Source Type: research

Suppression of high-fat diet-induced obesity-associated liver mitochondrial dysfunction by docosahexaenoic acid and hydroxytyrosol co-administration
Obesity-induced by high-fat diet (HFD) is associated with liver steatosis, oxidative stress and mitochondrial dysfunction, which can be eluded by the co-administration of the lipid metabolism modulator docosahexaenoic acid (DHA) and the antioxidant hydroxytyrosol (HT). (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - June 30, 2020 Category: Gastroenterology Authors: Macarena Ortiz, Sandra A. Soto-Alarc ón, Paula Orellana, Alejandra Espinosa, Cristian Campos, Sandra López-Arana, Miguel A. Rincón, Paola Illesca, Rodrigo Valenzuela, Luis A. Videla Tags: Liver, Pancreas and Biliary Tract Source Type: research

A multicentre, international, observational study on transarterial chemoembolisation in colorectal cancer liver metastases: Design and rationale of CIREL
About 70 –80% of patients with colorectal liver metastases appear as ineligible for a curative treatment approach. Transarterial chemoembolisation (TACE) using irinotecan-eluting beads has emerged as a promising treatment option in cases with irresectable liver metastases. Despite being in clinical practic e for years, little is known about the treatment characteristics and outcomes when used as per routine hospital practice. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - June 30, 2020 Category: Gastroenterology Authors: Philippe L. Pereira, Dirk Arnold, Thierry de Ba ère, Fernando Gomez, Thomas Helmberger, Roberto Iezzi, Geert Maleux, Hans Prenen, Bruno Sangro, Anders Nordlund, Bleranda Zeka, Robert Bauer, Nathalie Kaufmann, Olivier Pellerin, Julien Taieb Tags: Progress Report Source Type: research

Is tumor testing efficiency for Lynch syndrome different in rectal and colon cancer?
Tumor testing utility in Lynch syndrome (LS) diagnosis is established. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - June 30, 2020 Category: Gastroenterology Authors: Monica Marabelli, Sara Gandini, Paola Raviele Rafaniello, Mariarosaria Calvello, Gianluca Tolva, Irene Feroce, Matteo Lazzeroni, Elena Marino, Matteo Dal Molin, Cristina Trovato, Aliana Guerrieri-Gonzaga, Wanda Luisa Petz, Massimo Barberis, Lucio Bertario Tags: Oncology Source Type: research

Efficacy, safety and tolerability, the imperfect triangle arising from the new low volume colon preparations
Adequate bowel preparation is crucial for quality colonoscopy. It is widely recognized that a poor bowel preparation negatively influences all the primary quality indicators for colonoscopy: it reduces adenoma detection rate (ADR) and both cecal intubation and withdrawal time are prolonged in case of poor bowel preparation [1,2]. Since the consequences of inadequate bowel preparation are so significant, endoscopists set efficacy as the priority in judging and choosing a bowel preparation over another. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - June 30, 2020 Category: Gastroenterology Authors: Mario Schettino, Simone Saibeni, Cristina Bezzio, Germana de Nucci, Gianpiero Manes Tags: Correspondence Source Type: research

Colorectal cancer screening in Italy: A survey of gastroenterologists ’ clinical practices
Colorectal cancer (CRC) is a major cause of morbidity and mortality and is one of the most common tumors [1]. Because CRC has a common presentation and protracted disease course, it is an optimal candidate for early detection by screening [2 –4]. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - June 29, 2020 Category: Gastroenterology Authors: Renato Cannizzaro, 2018 FISMAD Scientific Committee Tags: Correspondence Source Type: research

Use of biosimilars in inflammatory bowel diseases: A survey among the clinicians members of the Italian Group for the Study of Inflammatory Bowel Disease (IGIBD)
Biosimilars are increasingly used in patients with inflammatory bowel diseases (IBD) as a cost-effective alternative option to the reference biologics that have gone off-patent –i.e. infliximab, adalimumab [1]. Their approval in IBD therapy in 2013 immediately gave rise to many concerns about immunogenicity, safety, and efficacy [2–4]. The greatest fear concerned the extrapolation of the indication to IBD from studies performed in other inflammatory diseases [3,4]. In the following years, an increasing number of clinical trials have gradually shown that biosimilars can be considered to be as safe and efficaciou...
Source: Digestive and Liver Disease - June 29, 2020 Category: Gastroenterology Authors: Angelo Viscido, Andrea Buda, Flavio Caprioli, Mariabeatrice Principi, Marco Daperno, Alessandro Armuzzi Tags: Correspondence Source Type: research

Long term remission after ileorectal anastomosis in Crohn's colitis
Crohn's disease represents a heterogeneous entity, but its location tends to be relatively stable overtime. For extensive refractory Crohn's colitis, ileorectal anastomosis after colectomy is an engaging option, since the necessity of a permanent ileostomy is avoided. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - June 29, 2020 Category: Gastroenterology Authors: Marco Salice, Fernando Rizzello, Dolores Sgambato, Carlo Calabrese, Francesco Manguso, Silvio Laureti, Matteo Rottoli, Gilberto Poggioli, Paolo Gionchetti Tags: Alimentary Tract Source Type: research

Performing endoscopy in a reorganised gastroenterology department during pandemic lockdown
We read with interest the recent article by Elli et al. [1], about the experience and recommendations for performing endoscopy during the Coronavirus Disease 2019 (COVID-19) pandemic. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - June 29, 2020 Category: Gastroenterology Authors: Renato Medas, Patr ícia Andrade, Pedro Moutinho-Ribeiro, Guilherme Macedo Tags: Correspondence Source Type: research

Loop ligation-assisted endoscopic resection of a gastrointestinal stromal tumor in the gastric fundus
A 37-year-old female, psychologically highly stressed patient was referred for one-stop endoscopic management of a subepithelial lesion (SEL) in the gastric fundus. Endoscopic ultrasound showed a homogenously echo-poor spherical lesion most likely from the inner muscular layer up to 25  mm without risk strata (irregular borders, cystic and/or echogenic foci or heterogeneity). (Fig. 1A) Likewise, EGD was consistent with an intraluminal-type gastrointestinal stromal tumor (GIST), essentially facilitating endoscopic resection. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - June 29, 2020 Category: Gastroenterology Authors: Vincent Zimmer, Bert Bier Tags: Image of the Month Source Type: research