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AHNS Series: Do you know your guidelines? Guideline recommendations for head and neck cancer of unknown primary site
This article reviews the clinical practice guidelines for head and neck oncology focusing on the management of head and neck cancers of unknown primary (CUP). The primary purpose of this series is to raise awareness of the current guidelines in head and neck oncology by reviewing the recommendations and the evidence supporting such recommendations, particularly those published by the National Comprehensive Cancer Network (NCCN). We review the importance of a thorough history and physical examination, the impact of the American Joint Committee on Cancer (AJCC) eighth edition changes and the importance of immunohistochemistr...
Source: Head and Neck - November 21, 2017 Category: ENT & OMF Authors: Antoine Eskander, Tamer Ghanem, Amit Agrawal, Tags: PRACTICE GUIDELINES Source Type: research

Transmission electron microscopy helpfulness in Whipple's disease masked by immunosuppressant therapy for arthritis
A 61‐year‐old woman received a diagnosis of undifferentiated non‐erosive arthritis in 2010 and assumed methotrexate and steroids in 2014. After 1 year, she experienced watery diarrhea, vomiting, fever, weight loss, and severe hypoalbuminemia, thus being admitted into our Unit. Esophagogastroduodenoscopy showed duodenal lymphangiectasia and duodenal biopsy samples several foamy PAS‐positive macrophages and villous subtotal atrophy. Transmission electron microscope demonstrated several extracellular and intracellular rod‐shaped bacteria (Tropheryma whipplei). Therefore, we diagnosed Whipple's disease. Our patient a...
Source: APMIS - November 20, 2017 Category: Research Authors: Alessandra Loiodice, Giuseppe Losurdo, Andrea Iannone, Roberta Rossi, Maria Grazia Fiore, Domenico Piscitelli Tags: Case Report Source Type: research

The Prevalence of Biopsy-Proven Eosinophilic Esophagitis in Hispanics Undergoing Endoscopy Is Infrequent Compared to Caucasians: A Cross-Sectional Study
ConclusionsHispanic patients at LAC and UMHCEP had a significantly lower prevalence of EOE as  compared to Caucasians at these two institutions and a lower prevalence as compared to Caucasians with EOE previously reported in the literature. Gene expression analysis, which has previously been shown to accurately diagnose EOE in Caucasian patients, accurately diagnosed EOE in a small samp le of this Hispanic population. Based on this similar gene expression, other factors such as environmental, ethnic, and cultural causes should be investigated to explain the markedly lower prevalence of EOE in Hispa...
Source: Digestive Diseases and Sciences - November 18, 2017 Category: Gastroenterology Source Type: research

Nonalcoholic Fatty Liver Disease Is Associated with Increased Risk of Reflux Esophagitis
ConclusionsIn this large cohort of Korean men and women, participants with NAFLD exhibited increased incidence of reflux esophagitis independent of possible confounders, suggesting that NAFLD contributes to the development of reflux esophagitis. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - November 18, 2017 Category: Gastroenterology Source Type: research

An Unusual Cause of Gastric Outlet Obstruction: A Pancreaticoduodenal Artery Aneurysm
We present a rare case of gastric outlet obstruction due to compression of the duodenum by a pancreaticoduodenal artery (PDA) aneurysm 2.5 cm in diameter, in a 43-year-old man from Saudi Arabia who presented with persistent vomiting and epigastric pain. The initial investigations and blood works were negative, and esophagogastroduodenoscopy (EGD) was unremarkable. A CT abdomen demonstrated a mass around the duodenum and dilatation of the stomach, and CT angiography showed the PDA aneurysm. The patient was stabilized and then referred to a tertiary center for embolization. Our case demonstrates a diagnostic challenge that p...
Source: Annals of Saudi Medicine - November 16, 2017 Category: General Medicine Tags: ISSUE 5 Source Type: research

Nonalcoholic Fatty Liver Disease and the Development of Reflux Esophagitis: A Cohort Study
Abstract Backgrounds/AimsNonalcoholic fatty liver disease (NAFLD), a hepatic manifestation of the metabolic syndrome, is associated with gastroesophageal reflux disease in cross‐sectional studies, but a prospective association has not been evaluated. The current study aimed to determine whether NAFLD increases the risk of incident reflux esophagitis in a large cohort study. MethodsWe conducted a cohort study of 34,063 men and women without reflux esophagitis or other upper gastrointestinal disease at baseline who underwent health check‐up examinations between January 2003 and December 2013. Fatty liver was diagnosed by...
Source: Journal of Gastroenterology and Hepatology - November 13, 2017 Category: Gastroenterology Authors: Yang Won Min, Youngha Kim, Geum ‐Youn Gwak, Seonhye Gu, Danbee Kang, Soo Jin Cho, Eliseo Guallar, Juhee Cho, Dong Hyun Sinn Tags: Gastroenterology Source Type: research

Abdominal ultrasound – the leading method in duodenal gist diagnostics.
ABDOMINAL ULTRASOUND – THE LEADING METHOD IN DUODENAL GIST DIAGNOSTICS. Acta Clin Croat. 2017 03;56(1):183-7 Authors: Bohnec S, Budimir I, Hrabar D, Babić N, Budimir I, Nikolić M, Pavić I Abstract Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract and are generally asymptomatic. A 39-year-old female patient was hospitalized in 2012 at Clinical Department of Internal Medicine, Sestre milosrdnice University Hospital Center, for a focal hypodense irregular circular lesion located in segment III of the left hepatic lobe, accidentally found by ultra...
Source: Acta Clinica Croatica - November 10, 2017 Category: General Medicine Tags: Acta Clin Croat Source Type: research

First progress report on the Japan Endoscopy Database project
Background and AimThe Japan Endoscopy Database (JED) Project was started to develop the world's largest endoscopic database, capture the actual performance of endoscopic practice, and standardize the terminology and fundamental items needed for a clinical and research registry. This paper presents a progress report on the first phase of this project undertaken at eight endoscopic centers in Japan. MethodsThe list of data items to be collected was drafted by the MSED‐J (Minimal Standard Endoscopic Database) subcommittee. These items were aggregated offline by integrating data from two endoscopic filing systems between Jul...
Source: Digestive Endoscopy - November 9, 2017 Category: Gastroenterology Authors: Shinya Kodashima, Kiyohito Tanaka, Koji Matsuda, Mitsuhiro Fujishiro, Yutaka Saito, Kazuo Ohtsuka, Ichiro Oda, Chikatoshi Katada, Masayuki Kato, Mitsuhiro Kida, Kiyonori Kobayashi, Shu Hoteya, Takahiro Horimatsu, Takahisa Matsuda, Manabu Muto, Hironori Ya Tags: Special Report Source Type: research

Overuse of Repeat Upper Endoscopy in the Veterans Health Administration: A Retrospective Analysis
Sameer D Saini (Source: The American Journal of Gastroenterology)
Source: The American Journal of Gastroenterology - November 7, 2017 Category: Gastroenterology Authors: Joel H Rubenstein Heiko Pohl Megan A Adams Eve Kerr Robert Holleman Sandeep Vijan Jason A Dominitz John M Inadomi Dawn Provenzale Joseph Francis Sameer D Saini Source Type: research

A case of diminutive duodenal deep submucosal invasive adenocarcinoma resected by endoscopic mucosal resection
This article is protected by copyright. All rights reserved. (Source: Digestive Endoscopy)
Source: Digestive Endoscopy - November 6, 2017 Category: Gastroenterology Authors: Naoki Yorita, Yoji Sanomura, Shinji Tanaka Tags: Letters, techniques and images Source Type: research

Upper GI involvement in children with familial adenomatous polyposis syndrome: single-center experience and meta-analysis of the literature
Familial adenomatous polyposis (FAP) is a hereditary syndrome that can affect the entire GI tract. Current screening recommendations include esophagogastroduodenoscopy (EGD) starting at age 25 to 30 years or earlier in symptomatic patients. However, there are few reports describing upper GI tract involvement in children with FAP which support the notion of early screening. The aim of our study is to understand the prevalence and severity of upper GI involvement in children with FAP. (Source: Gastrointestinal Endoscopy)
Source: Gastrointestinal Endoscopy - November 6, 2017 Category: Gastroenterology Authors: Luz H. Gutierrez Sanchez, Mouaz Alsawas, Michael Stephens, Mohammad Hassan Murad, Imad Absah Source Type: research

A Metastatic Gastric Tumor from Ovarian Cancer.
Authors: Kono M, Nagami Y, Ominami M, Sakai T, Fukuda T, Fukunaga S, Tanaka F, Sugimori S, Yamagami H, Tanigawa T, Shiba M, Tominaga K, Watanabe T, Fujiwara Y, Arakawa T Abstract Gastric metastasis from ovarian cancer has rarely been reported. We herein report the case of a 64-year-old woman with gastric metastasis from ovarian cancer that was diagnosed as surgical stage IA. Diagnostic and staging laparotomy showed mucinous carcinoma of the right ovary. At one month after surgery, bone metastasis was detected via scintigraphy. On esophagogastroduodenoscopy, a 10-mm elevated lesion with ulceration on the top was see...
Source: Internal Medicine - November 4, 2017 Category: Internal Medicine Tags: Intern Med Source Type: research

Primary aortoesophageal fistula: A fatal outcome
We reported a case of primary aortoesophageal fistula associated with thoracic aortic aneurysm. Esophagogastroduodenoscopy demonstrated a bulging erosive lesion coated with fibrin. The patient was therefore diagnosed as malignant esophageal mesenchymoma initially. An emergency contrast-enhanced computed tomography revealed an out-pouching saccular aneurysm protruding toward the esophagus at the level of T8-9. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 3, 2017 Category: Emergency Medicine Authors: Yang Yang, Die Hu, Daoquan Peng Source Type: research

Iron deficiency anemia in older adults: A review
Anemia in older adults is a risk factor for numerous negative outcomes. There is no standard definition, but in most studies, anemia is defined as a hemoglobin value
Source: Geriatrics and Gerontology International - November 2, 2017 Category: Geriatrics Authors: Etienne Joosten Tags: Review Article Source Type: research

An Unusual Finding During Evaluation of Iron Deficiency
Question: A 74-year-old vegetarian woman with a medical history significant for severe nonischemic dilated cardiomyopathy, chronic obstructive pulmonary disease, stage IV chronic kidney disease, hypertension, atrial fibrillation on chronic warfarin, and right-sided breast cancer treated with mastectomy>20 years ago, presented for evaluation of fatigue and a 16-year history of iron deficiency anemia. History was notable for an absence of melena, hematemesis, and bright red blood per rectum. Six years prior, she had undergone an upper endoscopy, which identified a Dieulafoy lesion that was treated with cauterization. (Sou...
Source: Gastroenterology - November 2, 2017 Category: Gastroenterology Authors: Alberto Rubio-Tapia, Isabel A. Hujoel, Tsung-Teh Wu Tags: Clinical Challenges and Images in GI Source Type: research

Liver stiffness measurement and spleen diameter as predictors for the presence of esophageal varices in chronic hepatitis C patients
Abstract Although it is an invasive and unpleasant procedure, esophagogastroduodenoscopy (EGD) is still the gold standard for esophageal varices (EV) detection. The aim of this study was to investigate liver stiffness measurement (LSM) and spleen diameter as simple noninvasive tools for EV prediction in chronic hepatitis C patients (CHC). A total of 123 Egyptian patients with CHC have been included and were classified based on screening EGD result into 2 groups; group A (without EV) and group B (with EV). Group (B) was subclassified according to EV grade into 4 subgroups: (B1, grade I), (B2, grade II), (B3, grade III), ...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Brunner Gland Adenoma
A 42-year-old man with a history of dyspepsia presented to the hospital with 2 weeks of epigastric pain, weakness, fatigue, dyspnea on exertion, and melenic stools. Labs were significant for a hemoglobin of 5.9 g/dL from a baseline of 14.2 g/dL (reference range, 13.5-17.5 g/dL). Esophagogastroduodenoscopy demonstrated a large pedunculated duodenal mass with surface erosions, extending from the pylorus into the third portion; on endoscopic ultrasound, the stalk appeared to originate from the submucosa and had prominent central vessels without evidence of varices. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - November 1, 2017 Category: Internal Medicine Authors: Lucas X. Marinacci, Farrin A. Manian Tags: Medical images Source Type: research

The relationship between esophageal acid exposure and the esophageal response to volumetric distention
Abstract BackgroundIncreased esophagogastric junction (EGJ) distensibility is thought to contribute to gastroesophageal reflux disease (GERD). Using the functional lumen imaging probe (FLIP), we aimed to assess the esophageal response to distension among patients undergoing esophageal pH monitoring. Methods25 patients (ages 22‐73; 13 females) who underwent ambulatory wireless esophageal pH testing while off proton‐pump inhibitors were evaluated with FLIP during sedated upper endoscopy. Esophageal reflux was quantified by total percent acid exposure time (AET;
Source: Neurogastroenterology and Motility - November 1, 2017 Category: Gastroenterology Authors: D. A. Carlson, P. Kathpalia, J. Craft, M. Tye, Z. Lin, P. J. Kahrilas, J. E. Pandolfino Tags: ORIGINAL ARTICLE Source Type: research

Massive Upper and Lower GI Bleed from Simultaneous Primary (AL) Amyloidosis of the Stomach and Transverse Colon in a Patient with Multiple Myeloma
We report a case of gastric and colonic amyloidosis on anticoagulation presenting with massive upper and lower GI bleeding. A 67-year-old lady known to have multiple myeloma and AL amyloidosis on rivaroxaban presented with massive upper GI bleeding. Esophagogastroduodenoscopy showed a mass lesion (3 × 7 cm) located along the greater curvature in the body/antrum with active bleeding. Mucosal biopsies revealed amyloid deposition. She underwent partial gastrectomy and recovered well after surgery, and was discharged home on rivaroxaban. The patient presented again 4 weeks after discharge with ble eding per rectum, and a...
Source: Case Reports in Gastroenterology - October 30, 2017 Category: Gastroenterology Source Type: research

Localized Gastric Amyloidosis with Kappa and Lambda Light Chain Co-Expression.
Authors: Ahn YH, Rhee YY, Choi SC, Seo GS Abstract Esophagogastroduodenoscopy for cancer screening was performed in a 55-year-old woman as part of a health screening program, and revealed a depressed lesion approximately 20 mm in diameter in the lesser curvature of the mid-gastric body. Several biopsy specimens were collected as the lesion resembled early gastric cancer; however, histopathologic evaluation revealed chronic active gastritis with an ulcer and amorphous eosinophilic material deposition. Congo red staining identified amyloid proteins, and apple-green birefringence was shown using polarized light micros...
Source: Clinical Endoscopy - October 28, 2017 Category: Gastroenterology Tags: Clin Endosc Source Type: research

Patterns of Relapse after Definitive Chemoradiotherapy in Stage II/III (Non-T4) Esophageal Squamous Cell Carcinoma.
CONCLUSION: Surveillance with esophagogastroduodenoscopy may be important in the first 3 years after dCRT to detect LR and to detect NC-E beyond 3 years. PMID: 29080886 [PubMed - as supplied by publisher] (Source: Oncology)
Source: Oncology - October 28, 2017 Category: Cancer & Oncology Authors: Sudo K, Kato K, Kuwabara H, Sasaki Y, Takahashi N, Shoji H, Iwasa S, Honma Y, Okita NT, Takashima A, Hamaguchi T, Yamada Y, Ito Y, Itami J, Fukuda T, Tobinai K, Boku N Tags: Oncology Source Type: research

Caught in the act
This report refers to 2 cases. A 72-year-old man, with past medical history of type 2 diabetes presented to the emergency department due to weakness and dark stools for one week. Laboratory data showed iron deficiency anaemia (8.2g/dL). He performed an upper endoscopy and a colonoscopy that were unremarkable. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - October 28, 2017 Category: Gastroenterology Authors: Rui Gaspar, Helder Cardoso, Rui Morais, Guilherme Macedo Tags: Image of the Month Source Type: research

Patterns of Relapse after Definitive Chemoradiotherapy in Stage II/III (Non-T4) Esophageal Squamous Cell Carcinoma
Conclusion: Surveillance with esophagogastroduodenoscopy may be important in the first 3 years after dCRT to detect LR and to detect NC-E beyond 3 years.Oncology (Source: Oncology)
Source: Oncology - October 27, 2017 Category: Cancer & Oncology Source Type: research

OR083 Medication use and drug allergies do not appear more frequent among patients with eosinophilic esophagitis
Acid-suppressive medications may interfere with the peptic digestion of food allergens. This may increase mucosal permeability and contribute to the development of food allergy and Eosinophilic Esophagitis (EOE). We hypothesized that reported acid suppression medication use would be more common in patients with EOE than non-EOE patients undergoing upper endoscopy. We also aimed to determine whether patients with EOE were more likely to report medication allergies. (Source: Annals of Allergy, Asthma and Immunology)
Source: Annals of Allergy, Asthma and Immunology - October 27, 2017 Category: Allergy & Immunology Authors: L. Rothstein, R. Miller, B. Lebwohl, P. Green, S. Lagana, R. Abdelmessih Source Type: research

Using Serum IgE Antibodies to Predict Esophageal Eosinophilia in Children
Conclusions: Requiring only a blood test and a simple algorithm, analysis for IgE antibodies to food may expedite an esophagogastroduodenoscopy and decrease delays in the diagnosis and treatment of patients with nonspecific gastrointestinal symptoms who have increased eosinophils in the esophagus. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - October 25, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Esophageal squamous cell neoplasia is an independent negative prognostic factor for head and neck cancer patients
ConclusionsOur study suggests that although the survival of HNC patients with ESCN may be improved by routine EGDS during tumor surveys and by advances in endoscopy, the presence of ESCN still remains an independent negative prognostic factor for HNC patients. (Source: International Journal of Clinical Oncology)
Source: International Journal of Clinical Oncology - October 24, 2017 Category: Cancer & Oncology Source Type: research

Erratum to: Is Routine Preoperative Esophagogastroduodenoscopy Screening Necessary Prior to Laparoscopic Sleeve Gastrectomy? Review of 1555 Cases and Comparison with Current Literature
(Source: Obesity Surgery)
Source: Obesity Surgery - October 22, 2017 Category: Surgery Source Type: research

Adult-Onset Henoch-Schonlein Purpura Duodenitis.
We report a 28-year-old female patient who presented with two episodes of hematemesis, worsening abdominal pain, and bloody diarrhea. Physical examination showed erythematous, palpable, purpuric rashes on her thighs and lower legs. Contrast-enhanced computed tomography (CT) scan showed thickening of the duodenal wall, and upper endoscopy revealed mild gastric erythema and diffuse erythematous, hemorrhagic, friable mucosa with superficial, thick, adherent white exudate seen in the second portion of the duodenum, consistent with the diagnosis of HSP. We report on the clinical presentation of our patient, and review adult-ons...
Source: Clin Med Res - October 19, 2017 Category: Research Authors: Ofori E, Ramai D, Ona MA, Papafragkakis C, Reddy M Tags: J Clin Med Res Source Type: research

Effect of the midazolam addition the propofol ‐based sedation in esophagogastroduodenoscopy: a randomized trial
ConclusionAdding midazolam to propofol did not reduced the safety and efficacy, sedation using propofol alone could be suitable for sedation during diagnostic EGD. (Source: Journal of Gastroenterology and Hepatology)
Source: Journal of Gastroenterology and Hepatology - October 19, 2017 Category: Gastroenterology Authors: Eun Hye Kim, Jun Chul Park, Sung Kwan Shin, Yong Chan Lee, Sang Kil Lee Tags: Endoscopy Source Type: research

Signet Ring Cell Carcinoma of Unknown Primary Origin Detected Incidentally by Lymph Node Purification for Thyroid Carcinoma.
Authors: Handa H, Gomi D, Fukushima T, Kobayashi T, Sekiguchi N, Sakamoto A, Tsukahara Y, Matsushita H, Sasaki S, Mamiya K, Koizumi T, Ichiyama T Abstract A 63-year-old woman underwent thyroidectomy for papillary thyroid adenocarcinoma and cervical lymph node resection. Pathological analyses revealed the presence of signet cell carcinoma in a resected lymph node, which were apparently different from the pathological findings of thyroid carcinoma. No evidence of a primary tumor could be found elsewhere despite detailed examinations, including esophagogastroduodenoscopy, colonoscopy, capsule endoscopy, CT scan, and f...
Source: Internal Medicine - October 18, 2017 Category: Internal Medicine Tags: Intern Med Source Type: research

Sclerosing Esophagitis with IgG4-positive Plasma Cell Infiltration: A Case Report.
Authors: Mori S, Tahashi Y, Uchida K, Ikeura T, Danbara N, Wakamatsu T, Kusuda T, Takahashi Y, Yanagawa M, Matsushita M, Ohe C, Michiura T, Inoue K, Kon M, Okazaki K Abstract The patient was a 76-year-old woman who had noticed slight difficulty in swallowing in the 3 years prior to this presentation. Her dysphagia progressed while she was hospitalized following cervical cancer surgery. Esophagogastroduodenoscopy and an esophagram showed circumferential erosion and a stricture of the thoracic esophagus. Esophageal resection was performed; the resected specimens showed a stricture and wall thickening. Histologically,...
Source: Internal Medicine - October 14, 2017 Category: Internal Medicine Tags: Intern Med Source Type: research

Gastric adenocarcinoma of fundic gland type spreading to heterotopic gastric glands.
Abstract Herein, we present a case of gastric adenocarcinoma of fundic gland type (GA-FG) spreading to heterotopic gastric glands (HGG) in the submucosa. A 58-year-old man with epigastric pain was referred to our hospital and underwent an esophagogastroduodenoscopy. A Borrmann type II gastric cancer at the antrum and a 10 mm submucosal tumor-like lesion in the lesser curvature of the upper third of the stomach were detected. Histological examination of the biopsy specimens obtained from the submucosal tumor-like lesion suggested a GA-FG. Therefore, endoscopic submucosal dissection was performed as excisional biops...
Source: World Journal of Gastroenterology - October 14, 2017 Category: Gastroenterology Authors: Manabe S, Mukaisho KI, Yasuoka T, Usui F, Matsuyama T, Hirata I, Boku Y, Takahashi S Tags: World J Gastroenterol Source Type: research

Reflux Hypersensitivity: A New Functional Esophageal Disorder.
Authors: Yamasaki T, Fass R Abstract Reflux hypersensitivity, recently introduced by Rome IV as a new functional esophageal disorder, is currently considered as the presence of typical heartburn symptoms in patients with normal upper endoscopy and esophageal biopsies, normal esophageal pH test and with evidence of a close correlation between patients' heartburn and reflux events. Reflux hypersensitivity is very common and together with functional heartburn accounts for more than 90% of the heartburn patients who failed treatment with proton pump inhibitor twice daily. In addition, reflux hypersensitivity affects pr...
Source: Journal of Neurogastroenterology and Motility - October 11, 2017 Category: Gastroenterology Tags: J Neurogastroenterol Motil Source Type: research

Hepatic artery aneurysm causing gastrointestinal haemorrhage – Case report and literature review
Conclusion In the case of treatment refractory duodenal haemorrhage, a visceral aneurysm should be considered. Even though angiography is performed, a HAA may remain undetected due to bleeding cessation. Improved computed tomography modalities could aid in the detection of gastrointestinal haemorrhage from HAAs, and ensure timely treatment by endovascular methods or surgery if the diagnosis is kept in mind in the initial evaluation. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - October 11, 2017 Category: Surgery Source Type: research

Continued Alcohol Misuse in Human Cirrhosis is Associated with an Impaired Gut –Liver Axis
ConclusionsDespite cirrhosis, continued alcohol misuse predisposes patients to widespread dysbiosis with alterations in microbial functionality such as a toxic BA profile, which can lead to intestinal and systemic inflammation. In patients with cirrhosis who continue to misuse alcohol, there is evidence of greater endotoxemia and systemic inflammation stemming from widespread intestinal mucosal dysbiosis and microbial functionality. This is perpetuated by an altered enterohepatic cycling of bile acids and overproduction of secondary bile acids in the setting of ileal inflammation. (Source: Alcoholism: Clinical and Experimental Research)
Source: Alcoholism: Clinical and Experimental Research - October 11, 2017 Category: Addiction Authors: Jasmohan S. Bajaj, Genta Kakiyama, Derrick Zhao, Hajime Takei, Andrew Fagan, Phillip Hylemon, Huiping Zhou, William M. Pandak, Hiroshi Nittono, Oliver Fiehn, Nita Salzman, Mary Holtz, Pippa Simpson, Edith A. Gavis, Douglas M. Heuman, Runping Liu, Dae Joon Tags: Original article Source Type: research

Clinical significance of small ‐bowel villous edema in patients with liver cirrhosis–a capsule endoscopy study
ConclusionsClinical factors related to portal hypertension were significantly correlated with VE. In particular PVT was correlated with the appearance and exacerbation of VE. Periodic CE in LC patients may lead to early detection of portal hypertension and PVT. (Source: Journal of Gastroenterology and Hepatology)
Source: Journal of Gastroenterology and Hepatology - October 10, 2017 Category: Gastroenterology Authors: Ichiro Otani, Shiro Oka, Shinji Tanaka, Akiyoshi Tsuboi, Sayoko Kunihara, Yuko Nagaoki, Hiroshi Aikata, Kazuaki Chayama Tags: Gastroenterology Source Type: research

Achalasia after bariatric Roux-en-Y gastric bypass surgery reversal.
We present a case of a 70-year-old female who had a previous history of Roux-en-Y gastric bypass with revision. She presented with persistent nausea and regurgitation for one month. Esophagogastroduodenoscopy showed a dilated esophagus without strictures or stenosis. A barium study was performed after the endoscopy and was suggestive of achalasia. Those findings were confirmed by a manometry. The patient was referred for laparoscopic Heller's myotomy. PMID: 29085233 [PubMed - in process] (Source: World Journal of Gastroenterology)
Source: World Journal of Gastroenterology - October 7, 2017 Category: Gastroenterology Authors: Abu Ghanimeh M, Qasrawi A, Abughanimeh O, Albadarin S, Clarkston W Tags: World J Gastroenterol Source Type: research

Aortic Valve Replacement for the Management of Heyde Syndrome: A Case Report.
Abstract Heyde syndrome describes the triad of aortic stenosis, acquired coagulopathy, and anemia due to bleeding from intestinal angiodysplasia. An 87-year-old man with iron deficiency anemia due to melena was admitted to our hospital. On examination, a systolic murmur was heard and echocardiography confirmed the presence of aortic stenosis. Esophagogastroduodenoscopy and colonoscopy were unremarkable. Capsule endoscopy and double balloon endoscopy revealed angiodysplasia throughout the small intestine. Laboratory investigations were significant for reduced plasma levels of high molecular weight von Willebrand fa...
Source: Journal of Nippon Medical School - October 6, 2017 Category: Universities & Medical Training Authors: Shibamoto A, Kawaratani H, Kubo T, Nishimura N, Sato S, Seki K, Sawada Y, Takaya H, Okura Y, Takeda K, Uejima M, Namisaki T, Moriya K, Mitoro A, Yamao J, Yoshiji H Tags: J Nippon Med Sch Source Type: research

An Unusual Cause of Dysphagia in an Elderly Female
Question: A 66-year-old woman came to our hospital complaining of dysphagia for 1 month. She denied a family history of gastrointestinal carcinoma and a history of previous surgery. Remarkable previous history of bronchiectasis in the past years and occurrence of hemoptysis several days before was provided. The patient denied alcohol consumption and smoking habits. Upon presentation, no positive findings were found on the physical examination or laboratory studies. Esophagogastroduodenoscopy revealed a smooth, hemispherical, 8-mm diameter lesion on the posterior side of her esophagus at the level of carina (Figure A). (Sou...
Source: Gastroenterology - October 6, 2017 Category: Gastroenterology Authors: Duanmin Hu, Chenyue Tang Tags: Electronic Clinical Challenges and Images in GI Source Type: research

Comparison of endoscopy and radiographic imaging for detection of esophageal inflammation and remodeling in adults with eosinophilic esophagitis
Eosinophil predominant mucosal inflammation is central to the diagnosis and activity assessment of eosinophilic esophagitis (EoE). Esophageal mural remodeling is an important consequence of EoE that is responsible for adverse events of dysphagia, food impaction, and esophageal stenosis. The aim of this study was to compare upper endoscopy (EGD) with barium upper gastrointestinal study (UGI) for the detection of esophageal inflammation and remodeling in adults with EoE. (Source: Gastrointestinal Endoscopy)
Source: Gastrointestinal Endoscopy - October 6, 2017 Category: Gastroenterology Authors: Matthew J. Nelson, Frank H. Miller, Nelson Moy, Angelika Zalewski, Nirmala Gonsalves, Dyanna Gregory, Ikuo Hirano Source Type: research

An Unusual Cause of Dysphagia in an Elderly Woman
Question: A 66-year-old woman came to our hospital complaining of dysphagia for 1 month. She denied a family history of gastrointestinal carcinoma and a history of previous surgery. Remarkable previous history of bronchiectasis in the past years and occurrence of hemoptysis several days before was provided. The patient denied alcohol consumption and smoking habits. Upon presentation, no positive findings were found on the physical examination or laboratory studies. Esophagogastroduodenoscopy revealed a smooth, hemispherical, 8-mm diameter lesion on the posterior side of her esophagus at the level of carina (Figure A). (Sou...
Source: Gastroenterology - October 6, 2017 Category: Gastroenterology Authors: Duanmin Hu, Chenyue Tang Tags: Electronic Clinical Challenges and Images in GI Source Type: research

Severe Esophageal Dysphagia, Weight Loss and Atrial Fibrillation: A Devastating Outcome
Question: A 63-year-old man with a history of ischemic heart disease and atrial fibrillation presented with new-onset esophageal dysphagia to solids. One week prior he underwent coronary artery bypass surgery and left atrial radiofrequency ablation (RFA) for atrial fibrillation. He was first evaluated by a gastroenterologist from an outside facility. Barium swallow showed smooth tapering elongated stenosis of the mid esophagus with proximal esophageal dilatation (Figure A). He underwent an esophagogastroduodenoscopy (EGD) and was treated for presumed severe Candida esophagitis, even though esophageal brushings and histopat...
Source: Gastroenterology - October 5, 2017 Category: Gastroenterology Authors: Omar Y. Mousa, Juan E. Corral, Frank J. Lukens Tags: Clinical Challenges and Images in GI Source Type: research

A Long-Lasting Dysphagia
Question: A 74-year-elderly woman was presented to the clinic to be treated for dysphagia, which had persisted for more than 5 years. Previously, repetitive botulinum injections for suspected hypercontractile esophagus had been implemented in an external clinic without any success. The present esophagogastroduodenoscopy revealed an elongated esophagus with tertiary contractions and reflux stage A according to the Los Angeles classification. Eosinophilic esophagitis was excluded histologically, and laboratory results showed no relevant pathologies. (Source: Gastroenterology)
Source: Gastroenterology - October 5, 2017 Category: Gastroenterology Authors: Thomas G öbel, Andree Boldt, Andreas Erhardt Tags: Electronic Clinical Challenges and Images in GI Source Type: research

Severe Esophageal Dysphagia, Weight Loss, and Atrial Fibrillation: A Devastating Outcome
Question: A 63-year-old man with a history of ischemic heart disease and atrial fibrillation presented with new-onset esophageal dysphagia to solids. One week prior he underwent coronary artery bypass surgery and left atrial radiofrequency ablation (RFA) for atrial fibrillation. He was first evaluated by a gastroenterologist from an outside facility. Barium swallow showed smooth tapering elongated stenosis of the mid esophagus with proximal esophageal dilatation (Figure A). He underwent an esophagogastroduodenoscopy (EGD) and was treated for presumed severe Candida esophagitis, even though esophageal brushings and histopat...
Source: Gastroenterology - October 5, 2017 Category: Gastroenterology Authors: Omar Y. Mousa, Juan E. Corral, Frank J. Lukens Tags: Clinical Challenges and Images in GI Source Type: research

Squamous cell lung carcinoma presenting as melena: a case report and review of the literature
Lung cancer has a predilection to widely metastasize to the liver, bone, brain and adrenal glands. Metastasis of primary lung tumors to the stomach is infrequent, with only sporadic cases reported. Most cases are asymptomatic and diagnosed post-mortem on autopsy. The incidence of symptomatic gastrointestinal metastases is extremely rare. Herein, we describe a case of gastric metastasis by squamous cell lung carcinoma, presenting as melena and diagnosed by esophagogastroduodenoscopy. To the best of our knowledge, only twenty other cases in the English literature have reported symptomatic gastric metastasis of lung cancer di...
Source: Rare Tumors - October 4, 2017 Category: Cancer & Oncology Source Type: research

Hepatic artery aneurysm causing gastrointestinal haemorrhage Case report and literature review
Conclusion In the case of treatment refractory duodenal haemorrhage, a visceral aneurysm should be considered. Even though angiography is performed, a HAA may remain undetected due to bleeding cessation. Improved computed tomography modalities could aid in the detection of gastrointestinal haemorrhage from HAAs, and ensure timely treatment by endovascular methods or surgery if the diagnosis is kept in mind in the initial evaluation. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - October 4, 2017 Category: Surgery Source Type: research

Current Management of Benign Epithelial Gastric Polyps
Opinion statementPurpose of review Benign epithelial gastric polyps, although typically asymptomatic, are identified incidentally on upper endoscopy in up to 23% of patients. These include fundic gland, hyperplastic, and adenomatous polyps. Their appropriate characterization is critical as some have malignant potential, may be indicative of a gastric mucosal field defect, or may be related to an underlying polyposis syndrome. This review will discuss the current management of benign epithelial gastric polyps.Recent findings Association of gastric polyps with proton pump inhibitor use,Helicobacter pylori infection, risk of ...
Source: Current Treatment Options in Gastroenterology - October 3, 2017 Category: Gastroenterology Source Type: research

Outcomes of patients hospitalized with peptic ulcer disease diagnosed in acute upper endoscopy
Conclusion: PUD is still the most common cause for acute upper endoscopy with very low short-term mortality. Comorbidity, but not the stigmata of bleeding, was associated with decreased long-term survival. (Source: European Journal of Gastroenterology and Hepatology)
Source: European Journal of Gastroenterology and Hepatology - October 2, 2017 Category: Gastroenterology Tags: Original Articles: Gastro-esophageal Disorders Source Type: research

Diagnostic value of upper endoscopy for anastomotic complications after Roux-en-Y gastric bypass
This study aimed to identify patient characteristics that are associated with an abnormal outcome of EGD in patients who underwent LRYGB. (Source: Surgery for Obesity and Related Diseases)
Source: Surgery for Obesity and Related Diseases - October 1, 2017 Category: Surgery Authors: Thomas Boerlage, Paula Wolvers, Rogier Voermans, Barbara Hutten, Victor Gerdes Source Type: research

Utility of Flexible Upper Endoscopy in Early Postoperative Period After RYGB
Flexible upper endoscopy (FUE) is an important therapeutic and diagnostic tool in management of patients with upper gastrointestinal disease. We analyzed the utility of FUE in patients within 35 days after laparoscopic Roux-en-Y gastric bypass (RYGB) (Source: Surgery for Obesity and Related Diseases)
Source: Surgery for Obesity and Related Diseases - October 1, 2017 Category: Surgery Authors: Olga Beresneva, Donald Hess Source Type: research