Background and Aims: The aim of this study was to investigate the relationship between celiac disease and Helicobacter pylori infection and to compare the severity of celiac disease and Helicobacter pylori infection in adults according to the modified Marsh score. Materials and Methods: This study included 148 patients with celiac disease and 240 control patients without celiac disease who underwent endoscopy for various reasons in a tertiary hospital. Age, gender, endoscopy indications, descriptive characteristics, complaints, serological, endoscopic and histopathological findings of the patients were recorded and analyzed. Results: Helicobacter pylori colonization in the celiac disease patients was 43.9% and in control group was 57.5% (p = 0.009). Helicobacter pylori positivity rate was significantly lower in Marsh 2, 3A, 3B, 3C groups ( p = 0.04). Pearson correlation analysis revealed a significant but weak negative relationship between the severity of Helicobacter pylori and celiac disease (r = -.109, p = 0.031). When Marsh score was increasing, Helicobacter pylori grade decreased. Conclusion: The current study indicated that the incidence of Helicobacter pylori infection was lower in adults with celiac disease compared to control patients, and Helicobacter pylori colonization density was associated with milder duodenal lesions in celiac patients. Helicobacter pylori colonization may have a protective role in the development of celiac disease.
{"title":"Helicobacter pylori kolonizasyon yoğunluğu çölyak hastalığının gelişmesinde önemli rol oynayabilir","authors":"Mevlüt Kiyak, Tolga Düzenli","doi":"10.17941/agd.1271863","DOIUrl":"https://doi.org/10.17941/agd.1271863","url":null,"abstract":"Background and Aims: The aim of this study was to investigate the relationship between celiac disease and Helicobacter pylori infection and to compare the severity of celiac disease and Helicobacter pylori infection in adults according to the modified Marsh score. \u0000Materials and Methods: This study included 148 patients with celiac disease and 240 control patients without celiac disease who underwent endoscopy for various reasons in a tertiary hospital. Age, gender, endoscopy indications, descriptive characteristics, complaints, serological, endoscopic and histopathological findings of the patients were recorded and analyzed. Results: Helicobacter pylori colonization in the celiac disease patients was 43.9% and in control group was 57.5% (p = 0.009). Helicobacter pylori positivity rate was significantly lower in Marsh 2, 3A, 3B, 3C groups ( p = 0.04). Pearson correlation analysis revealed a significant but weak negative relationship between the severity of Helicobacter pylori and celiac disease (r = -.109, p = 0.031). When Marsh score was increasing, Helicobacter pylori grade decreased. Conclusion: The current study indicated that the incidence of Helicobacter pylori infection was lower in adults with celiac disease compared to control patients, and Helicobacter pylori colonization density was associated with milder duodenal lesions in celiac patients. Helicobacter pylori colonization may have a protective role in the development of celiac disease.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115811350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Esophageal squamous cell papilloma is an uncommon epithelial lesion of the esophagus. Epidemiological data regarding esophageal squamous cell papilloma in children is scarce and consists of few case reports. Although the etiology of esophageal squamous cell papilloma remains unclear, chemical/mechanical irritation induced hyper-regenerative response of esophageal mucosa and human papillomavirus infection have been suggested as most probable causes. A case of a 14-year-old girl with cystic fibrosis and chronic dyspepsia had a 0.5 x 0.5 cm sessile, multilobulated, whitish and verrucous polypoid mass close to the lower esophageal sphincter removed. Histologically, a benign squamous papilloma was confirmed. Her dyspeptic symptoms suggestive for gastroesophageal reflux resolved after papilloma removal and anti-acid treatment. Esophageal squamous cell papilloma is an incidental finding at upper endoscopy. Gastroesophageal reflux disease may be responsible for distally localized papillomas. Due to its rarity in childhood, there are not any well-established management and surveillance guidelines. Esophageal squamous cell papilloma should be removed, when possible, because of the ambiguity about its malignant potential.
食管鳞状细胞乳头状瘤是一种罕见的食管上皮病变。关于儿童食管鳞状细胞乳头状瘤的流行病学资料很少，病例报告也很少。虽然食管鳞状细胞乳头状瘤的病因尚不清楚，但化学/机械刺激诱导的食管黏膜超再生反应和人乳头状瘤病毒感染被认为是最可能的原因。一例14岁女孩囊性纤维化和慢性消化不良，切除了靠近下食管括约肌的0.5 x 0.5 cm的无根、多分叶、白色、疣状息肉样肿块。组织学证实为良性鳞状乳头状瘤。她的消化不良症状提示胃食管反流后消除乳头状瘤和抗酸治疗。食管鳞状细胞乳头状瘤是上内镜的偶然发现。胃食管反流病可能是远端局限性乳头状瘤的病因。由于其在儿童时期罕见，没有任何完善的管理和监测指南。食管鳞状细胞乳头状瘤应尽可能切除，因为其恶性潜能不明确。
{"title":"Esophageal squamous cell papilloma in a child with cystic fibrosis: A rare incidental endoscopic finding","authors":"E. Gümüş, D. Orhan, İ. S. Saltık Temizel","doi":"10.17941/agd.1268799","DOIUrl":"https://doi.org/10.17941/agd.1268799","url":null,"abstract":"Esophageal squamous cell papilloma is an uncommon epithelial lesion of the esophagus. Epidemiological data regarding esophageal squamous cell papilloma in children is scarce and consists of few case reports. Although the etiology of esophageal squamous cell papilloma remains unclear, chemical/mechanical irritation induced hyper-regenerative response of esophageal mucosa and human papillomavirus infection have been suggested as most probable causes. A case of a 14-year-old girl with cystic fibrosis and chronic dyspepsia had a 0.5 x 0.5 cm sessile, multilobulated, whitish and verrucous polypoid mass close to the lower esophageal sphincter removed. Histologically, a benign squamous papilloma was confirmed. Her dyspeptic symptoms suggestive for gastroesophageal reflux resolved after papilloma removal and anti-acid treatment. Esophageal squamous cell papilloma is an incidental finding at upper endoscopy. Gastroesophageal reflux disease may be responsible for distally localized papillomas. Due to its rarity in childhood, there are not any well-established management and surveillance guidelines. Esophageal squamous cell papilloma should be removed, when possible, because of the ambiguity about its malignant potential.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121592510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sirotik hastaların %50’ye yakınında özofagus ve gastrik varisler gelişir. Varisli siroz hastalarında dekompansasyon bulgusu olarak varis kanaması görülebilmektedir. Kanamalar sıklıkla özofageal varis kaynaklı kanamalardır. Gastrik varisler daha nadir kanar; ancak daha ciddi ve mortalitesi yüksek kanamalara neden olurlar. Gastrik varisler özofagus varisleri ile karşılaştırıldığında daha geniş çapta ve submukozal alanda daha derine uzanım gösterebilirler. Bu nedenle özofagus varisleri için yapılan standart endoskopik tedaviler büyük oranda etkisizdir. Siyanoakrilat tedavisinde septik ve embolik komplikasyonlar görülebildiği bildirilmiştir. Olgumuzda akut gastrik varis kanaması ile başvuran siroz hastasında siyanoakrilat tedavisi sonrası gelişen pulmoner emboli olgusu sunulmuştur.
{"title":"Cyanoacrylate associated pulmonary embolism: A case report","authors":"","doi":"10.17941/agd.1277055","DOIUrl":"https://doi.org/10.17941/agd.1277055","url":null,"abstract":"Sirotik hastaların %50’ye yakınında özofagus ve gastrik varisler gelişir. Varisli siroz hastalarında dekompansasyon bulgusu olarak varis kanaması görülebilmektedir. Kanamalar sıklıkla özofageal varis kaynaklı kanamalardır. Gastrik varisler daha nadir kanar; ancak daha ciddi ve mortalitesi yüksek kanamalara neden olurlar. Gastrik varisler özofagus varisleri ile karşılaştırıldığında daha geniş çapta ve submukozal alanda daha derine uzanım gösterebilirler. Bu nedenle özofagus varisleri için yapılan standart endoskopik tedaviler büyük oranda etkisizdir. Siyanoakrilat tedavisinde septik ve embolik komplikasyonlar görülebildiği bildirilmiştir. Olgumuzda akut gastrik varis kanaması ile başvuran siroz hastasında siyanoakrilat tedavisi sonrası gelişen pulmoner emboli olgusu sunulmuştur.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127833102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giriş ve Amaç: Kovalent olarak kapalı dairesel DNA düzeyinin kronik hepatit B hastalarında hastalığın aktivitesini öngörmede klinik önemi bulunmaktadır. Kovalent olarak kapalı dairesel DNA düzeyinin dolaylı bir göstergesi olan hepatit B yüzey antijeni düzeyi, kronik hepatit B hastalarının yönetiminde hepatit B virüs-DNA düzeyi ile birlikte önemli rol alabilir. Çalışmamızda, hepatit B nedeni ile karaciğer biyopsisi yapılan hastaların fibrozis skorları, hepatit B virüs-DNA ve hepatit B yüzey antijeni seviyelerinin hepatit B zarf antijeni durumu dikkate alınarak kıyaslanması amaçlandı. Gereç ve Yöntem: 2017-2020 yılları arasında kronik hepatit B nedeni ile karaciğer biyopsisi yapılan hastaların biyopsi sonuçları, retrospektif kesitsel olarak değerlendirildi. Biyopsi sonucunda fibrozis değerleri hepatit B zarf antijeni durumu göz önüne alınarak değerlendirildi. Bulgular: Çalışma grubunu 71 (%55.4) erkek, 57 (%44.5) kadın toplam 128 hasta oluşturdu. Ortalama yaş erkeklerde 41.58 ± 14.27, kadınlarda 43.63 ± 12.13 idi (p: 0.38). Hepatit B zarf antijeni pozitif hastalarda hepatit B yüzey antijeninin hepatit B virüs-DNA (p:
{"title":"HbsAg seviyesinin HBV DNA ve karaciğer fibrozisi ile ilişkisi","authors":"Ahmet Ramiz Baykan, Elmas Kasap","doi":"10.17941/agd.1273939","DOIUrl":"https://doi.org/10.17941/agd.1273939","url":null,"abstract":"Giriş ve Amaç: Kovalent olarak kapalı dairesel DNA düzeyinin kronik hepatit B hastalarında hastalığın aktivitesini öngörmede klinik önemi bulunmaktadır. Kovalent olarak kapalı dairesel DNA düzeyinin dolaylı bir göstergesi olan hepatit B yüzey antijeni düzeyi, kronik hepatit B hastalarının yönetiminde hepatit B virüs-DNA düzeyi ile birlikte önemli rol alabilir. Çalışmamızda, hepatit B nedeni ile karaciğer biyopsisi yapılan hastaların fibrozis skorları, hepatit B virüs-DNA ve hepatit B yüzey antijeni seviyelerinin hepatit B zarf antijeni durumu dikkate alınarak kıyaslanması amaçlandı. Gereç ve Yöntem: 2017-2020 yılları arasında kronik hepatit B nedeni ile karaciğer biyopsisi yapılan hastaların biyopsi sonuçları, retrospektif kesitsel olarak değerlendirildi. Biyopsi sonucunda fibrozis değerleri hepatit B zarf antijeni durumu göz önüne alınarak değerlendirildi. Bulgular: Çalışma grubunu 71 (%55.4) erkek, 57 (%44.5) kadın toplam 128 hasta oluşturdu. Ortalama yaş erkeklerde 41.58 ± 14.27, kadınlarda 43.63 ± 12.13 idi (p: 0.38). Hepatit B zarf antijeni pozitif hastalarda hepatit B yüzey antijeninin hepatit B virüs-DNA (p:","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122622025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Sarıtaş, Şehmus Ölmez, A. Tas, Nevin AKÇAER ÖZTÜRK, B. Kara
Background and Aims: Gastrointestinal bleeding is an emergent condition in clinical practice. Early diagnosis and proper treatment of the lesion is essential. Dieulafoy's lesion is an aberrant submucosal vessel eroding surrounding mucosa. These lesions cause of 1-2% of all gastrointestinal bleedings. Here we report cases with Dieulafoy's lesion presenting with upper gastrointestinal bleeding. Materials and Methods: Through a time frame of between August 2017-August 2021, patients admitted to our hospital presenting with upper gastrointestinal bleeding and diagnosed as Dieulafoy’s lesion were included in the study. Patients' files were screened retrospectively. Results: The study included 30 patients with a mean age of 65.9 ± 18.2 (20 - 92) years. Half of them were female. The most observed presentations were melena, hematemesis, and hematochezia. Associated diseases were hypertension, atherosclerotic heart disease and diabetes mellitus. In 26 (86.7%) patients, Dieulafoy's lesion was diagnosed in first endoscopy, while in four patients Dieulafoy's lesion was diagnosed in second endoscopy. Time interval between hospital admission to first endoscopy was 3.1 ± 2.5 (1 - 10) hours. In 23 patients Dieulafoy's lesion was in the stomach and in 6 patients in duodenum and in 1 patient in esophagus. Endoscopic therapy was applied to all patients. The most applied treatment modality was sclerotherapy + hemoclip application. One patient had required surgery due to recurrent bleeding. Six patients died. Three of them was bleeding related. Conclusion: Dieulafoy's lesion is a rare but serious cause of gastrointestinal bleedings. Early diagnosis and proper treatment is important. Patients may need repeated endoscopy for diagnosis. Hemoclip application is cheap, easy, safe, and effective treatment modality with/without sclerotherapy.
{"title":"Retrospective analysis of patients with Dieulafoy’s lesions","authors":"B. Sarıtaş, Şehmus Ölmez, A. Tas, Nevin AKÇAER ÖZTÜRK, B. Kara","doi":"10.17941/agd.1322148","DOIUrl":"https://doi.org/10.17941/agd.1322148","url":null,"abstract":"Background and Aims: Gastrointestinal bleeding is an emergent condition in clinical practice. Early diagnosis and proper treatment of the lesion is essential. Dieulafoy's lesion is an aberrant submucosal vessel eroding surrounding mucosa. These lesions cause of 1-2% of all gastrointestinal bleedings. Here we report cases with Dieulafoy's lesion presenting with upper gastrointestinal bleeding. Materials and Methods: Through a time frame of between August 2017-August 2021, patients admitted to our hospital presenting with upper gastrointestinal bleeding and diagnosed as Dieulafoy’s lesion were included in the study. Patients' files were screened retrospectively. Results: The study included 30 patients with a mean age of 65.9 ± 18.2 (20 - 92) years. Half of them were female. The most observed presentations were melena, hematemesis, and hematochezia. Associated diseases were hypertension, atherosclerotic heart disease and diabetes mellitus. In 26 (86.7%) patients, Dieulafoy's lesion was diagnosed in first endoscopy, while in four patients Dieulafoy's lesion was diagnosed in second endoscopy. Time interval between hospital admission to first endoscopy was 3.1 ± 2.5 (1 - 10) hours. In 23 patients Dieulafoy's lesion was in the stomach and in 6 patients in duodenum and in 1 patient in esophagus. Endoscopic therapy was applied to all patients. The most applied treatment modality was sclerotherapy + hemoclip application. One patient had required surgery due to recurrent bleeding. Six patients died. Three of them was bleeding related. Conclusion: Dieulafoy's lesion is a rare but serious cause of gastrointestinal bleedings. Early diagnosis and proper treatment is important. Patients may need repeated endoscopy for diagnosis. Hemoclip application is cheap, easy, safe, and effective treatment modality with/without sclerotherapy.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130222328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Akın, Öykü Tayfur Yürekli, M. Tahtacı, O. Ersoy
Background and Aims: Coronavirus disease-2019 is an emerging disease of global public health concern. We aimed to evaluate the demographic data, clinical properties, risk factors and endoscopy findings of coronavirus disease-2019 patients with upper gastrointestinal system bleeding. Materials and Method: Patients who underwent endoscopy for upper gastrointestinal bleeding between July 2, 2020 and January 29, 2021 and were diagnosed with severe acute respiratory syndrome coronavirus-2 confirmed by polymerase chain reaction were included in the study. In this retrospective study patients with gastrointestinal bleeding were compared as 1:2 case-control. Coronavirus disease-2019 patients who underwent endoscopy for upper gastrointestinal bleeding and the control group were compared retrospectively in terms of demographic data, comorbid diseases, bleeding symptom, drugs administered, laboratory parameters, time between bleeding symptom and endoscopy, endoscopy findings, gastrointestinal bleeding treatment, and mortality rates. Results: Forty Covid-19 patients (23 males, mean age ± SD, 65.92 ± 12.97) and 80 non-Covid-19 control patients (43 males, mean age ± SD, 66.17 ± 15.61) who underwent endoscopy for upper gastrointestinal bleeding were compared. The most common bleeding symptom was melena in both groups (50% vs 60%). Hospitalization in intensive care unit (47.5% vs 20%, P = 0.004) and need for mechanic ventilation (22.5% vs 5%, p = 0.006), use of corticosteroids were more common in coronavirus disease-2019 group (30% vs. 2.5%, p = 0.000). The need for erythrocyt replacement were not different between the groups [median (min - max) 1.5 (0 - 13) vs 0.5 (0 - 22), p = 0.397]. Use of low molecular weight heparin was statistically more common in coronavirus disease-2019 group (32.5% vs 5%, p=0.00). Time elapsed until the performance of endoscopy in terms of hours was significantly longer in coronavirus disease-2019 group (62.97 ± 84.59 vs. 21.85 ± 33.91, p = 0.006). The most common endoscopic finding was gastroduodenal ulcer in both groups. No significant differences were seen in terms of rebleeeding rates. Mortality rate was statistically higher in coronavirus disease-2019 group (37.5% vs 8.8%, p = 0.000). Conclusions: Until more precise guidelines for the management of gastrointestinal bleeding in COVID-19 patients are developed, a case-by-case decision should be made on whether to perform endoscopy and the timing of the procedure, after multidisciplinary assessments are made in terms of patient status, response to medical therapy, treatment resources, and assessment of risks.
背景与目的:冠状病毒病(2019)是一种引起全球公共卫生关注的新兴疾病。我们旨在评估冠状病毒病-2019上消化道出血患者的人口统计学资料、临床特征、危险因素和内镜检查结果。材料与方法:选取2020年7月2日至2021年1月29日期间因上消化道出血行内镜检查且经聚合酶链反应确诊为严重急性呼吸综合征冠状病毒-2的患者为研究对象。在本回顾性研究中，胃肠道出血患者以1:2的病例对照进行比较。回顾性比较冠状病毒病-2019上消化道出血内镜患者与对照组的人口学资料、合并症、出血症状、给药药物、实验室参数、出血症状与内镜检查时间、内镜检查结果、胃肠道出血治疗和死亡率。结果:40例新冠肺炎患者(男性23例，平均年龄±SD 65.92±12.97)与80例非新冠肺炎对照患者(男性43例，平均年龄±SD 66.17±15.61)行上消化道出血内镜检查。两组中最常见的出血症状是黑痘(50% vs 60%)。重症监护病房住院(47.5%对20%，P = 0.004)、机械通气需求(22.5%对5%，P = 0.006)、皮质类固醇的使用在冠状病毒病-2019组中更为常见(30%对2.5%，P = 0.000)。两组间红细胞替代需求无差异[中位数(最小-最大)1.5 (0 - 13)vs 0.5 (0 - 22)， p = 0.397]。在冠状病毒病-2019组中，低分子肝素的使用在统计学上更为常见(32.5%比5%，p=0.00)。冠状病毒病-2019组内镜检查时间(62.97±84.59∶21.85±33.91,p = 0.006)明显延长。两组中最常见的内镜发现是胃十二指肠溃疡。再出血率方面没有明显差异。冠状病毒病-2019组死亡率更高(37.5% vs 8.8%， p = 0.000)。结论:在制定更精确的COVID-19患者胃肠道出血管理指南之前，应在对患者状况、药物治疗反应、治疗资源和风险评估等进行多学科评估后，根据具体情况决定是否进行内窥镜检查和手术时机。
{"title":"Endoscopic findings are not different in patients with upper gastrointestinal bleeding with COVID-19","authors":"F. Akın, Öykü Tayfur Yürekli, M. Tahtacı, O. Ersoy","doi":"10.17941/agd.1275659","DOIUrl":"https://doi.org/10.17941/agd.1275659","url":null,"abstract":"Background and Aims: Coronavirus disease-2019 is an emerging disease of global public health concern. We aimed to evaluate the demographic data, clinical properties, risk factors and endoscopy findings of coronavirus disease-2019 patients with upper gastrointestinal system bleeding. Materials and Method: Patients who underwent endoscopy for upper gastrointestinal bleeding between July 2, 2020 and January 29, 2021 and were diagnosed with severe acute respiratory syndrome coronavirus-2 confirmed by polymerase chain reaction were included in the study. In this retrospective study patients with gastrointestinal bleeding were compared as 1:2 case-control. Coronavirus disease-2019 patients who underwent endoscopy for upper gastrointestinal bleeding and the control group were compared retrospectively in terms of demographic data, comorbid diseases, bleeding symptom, drugs administered, laboratory parameters, time between bleeding symptom and endoscopy, endoscopy findings, gastrointestinal bleeding treatment, and mortality rates. Results: Forty Covid-19 patients (23 males, mean age ± SD, 65.92 ± 12.97) and 80 non-Covid-19 control patients (43 males, mean age ± SD, 66.17 ± 15.61) who underwent endoscopy for upper gastrointestinal bleeding were compared. The most common bleeding symptom was melena in both groups (50% vs 60%). Hospitalization in intensive care unit (47.5% vs 20%, P = 0.004) and need for mechanic ventilation (22.5% vs 5%, p = 0.006), use of corticosteroids were more common in coronavirus disease-2019 group (30% vs. 2.5%, p = 0.000). The need for erythrocyt replacement were not different between the groups [median (min - max) 1.5 (0 - 13) vs 0.5 (0 - 22), p = 0.397]. Use of low molecular weight heparin was statistically more common in coronavirus disease-2019 group (32.5% vs 5%, p=0.00). Time elapsed until the performance of endoscopy in terms of hours was significantly longer in coronavirus disease-2019 group (62.97 ± 84.59 vs. 21.85 ± 33.91, p = 0.006). The most common endoscopic finding was gastroduodenal ulcer in both groups. No significant differences were seen in terms of rebleeeding rates. Mortality rate was statistically higher in coronavirus disease-2019 group (37.5% vs 8.8%, p = 0.000). Conclusions: Until more precise guidelines for the management of gastrointestinal bleeding in COVID-19 patients are developed, a case-by-case decision should be made on whether to perform endoscopy and the timing of the procedure, after multidisciplinary assessments are made in terms of patient status, response to medical therapy, treatment resources, and assessment of risks.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123505375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kolonda inverted divertikül kolonoskopide nadir görülebilen bir bulgudur. Rektumda inverted divertikül görülmesi ise çok daha nadirdir. Kolonda inverted divertiküller, kolon poliplerine benzerler. Tüm polypoid lezyonlarda dışlanmalıdırlar. Poliplerden ayırt edilmesi, polipektomi yapılması durumunda kolon perforasyonu olma riski nedeniyle çok önemlidir. İnverted rektal divertiküller kolonoskopi sırasında çok nadiren görülürler. Burada rektumda inverted divertikül saptanan nadir görülen bir vakayı sunacağız.
{"title":"İnverte rektal divertikül: Nadir bir kolonoskopik bulgu","authors":"","doi":"10.17941/agd.1263385","DOIUrl":"https://doi.org/10.17941/agd.1263385","url":null,"abstract":"Kolonda inverted divertikül kolonoskopide nadir görülebilen bir bulgudur. Rektumda inverted divertikül görülmesi ise çok daha nadirdir. Kolonda inverted divertiküller, kolon poliplerine benzerler. Tüm polypoid lezyonlarda dışlanmalıdırlar. Poliplerden ayırt edilmesi, polipektomi yapılması durumunda kolon perforasyonu olma riski nedeniyle çok önemlidir. İnverted rektal divertiküller kolonoskopi sırasında çok nadiren görülürler. Burada rektumda inverted divertikül saptanan nadir görülen bir vakayı sunacağız.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121495719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giriş ve Amaç: Çift balonlu enteroskopi ince bağırsak anormalliklerinin tanısının konulması ve girişimsel işlemlerinin yapılmasında önemli bir prosedürdür. Bu çalışmada Doğu Karadeniz Bölgesi’ndeki çift balonlu enteroskopi işlemi uygulanan hastaların değerlendirilmesi planlandı. Gereç ve Yöntem: Bu çalışmada Ağustos 2017 - Ocak 2023 tarihleri arasında; hastaların çift balonlu enteroskopi yapılma endikasyonları, demografik özellikleri, laboratuvar tetkikleri, görüntüleme yöntemleri, endoskopik bulguları, histopatolojik sonuçları, endoskopik girişimsel işlemler ve komplikasyonları retrospektif olarak değerlendirildi. Bulgular: Hastaların 30’u (%56) erkek, 24’ü (%44) kadın olup, ortanca enteroskopi yapılma yaşı 52 (17 - 84) /yıldı. En sık çift balonlu enteroskopi yapılma endikasyonları gizli gastrointestinal kanama (%28) ve aşikar gastrointestinal kanama (%22) idi. Enteroskopide en sık izlenen lezyon ülser, inflamasyon veya mukozal lezyon (%17) ve en sık konulan tanı Crohn hastalığı (%15) idi. Görüntüleme tetkikleri normal olan 10 hastanın 4’ünün (%40) endoskopi bulguları anormal idi ve bu hastalar adenokarsinom (%10), polip (%10), anjiodisplazi (%10) ve Crohn hastalığı (%10) tanıları aldı. Endoskopi bulguları normal olan, fakat görüntüleme yöntemlerinde anormallik izlenen 1 (%4) hastaya lenfoma tanısı konuldu. Çift balonlu enteroskopi yapılma endikasyonu gastrointestinal kanama olan hastalarda, sıklıkla tümöral (%11) ve vasküler lezyonlar (%11) izlendi ve bu hastaların çoğuna kanser ve anjiodisplazi tanısı konuldu. Gastrointestinal kanama dışındaki nedenler ile çift balonlu enteroskopi yapılan hastalarda ise, en sık ülser, inflamasyon veya mukozal lezyon (%33) tespit edildi ve bu hastaların çoğuna Crohn hastalığı (%26) tanısı konuldu. Sonuç: Çift balonlu enteroskopi ince bağırsak hastalıklarının tanısının konulmasında ve terapötik işlemlerin yapılmasında etkili ve güvenli bir prosedürdür. Bununla birlikte, ince bağırsak hastalığı için çift balonlu enteroskopi yanında klinik ve radyolojik bulgularda dikkate alınmalıdır.
{"title":"Double-balloon enteroscopy: The single center experience","authors":"M. Erkut","doi":"10.17941/agd.1338384","DOIUrl":"https://doi.org/10.17941/agd.1338384","url":null,"abstract":"Giriş ve Amaç: Çift balonlu enteroskopi ince bağırsak anormalliklerinin tanısının konulması ve girişimsel işlemlerinin yapılmasında önemli bir prosedürdür. Bu çalışmada Doğu Karadeniz Bölgesi’ndeki çift balonlu enteroskopi işlemi uygulanan hastaların değerlendirilmesi planlandı. Gereç ve Yöntem: Bu çalışmada Ağustos 2017 - Ocak 2023 tarihleri arasında; hastaların çift balonlu enteroskopi yapılma endikasyonları, demografik özellikleri, laboratuvar tetkikleri, görüntüleme yöntemleri, endoskopik bulguları, histopatolojik sonuçları, endoskopik girişimsel işlemler ve komplikasyonları retrospektif olarak değerlendirildi. Bulgular: Hastaların 30’u (%56) erkek, 24’ü (%44) kadın olup, ortanca enteroskopi yapılma yaşı 52 (17 - 84) /yıldı. En sık çift balonlu enteroskopi yapılma endikasyonları gizli gastrointestinal kanama (%28) ve aşikar gastrointestinal kanama (%22) idi. Enteroskopide en sık izlenen lezyon ülser, inflamasyon veya mukozal lezyon (%17) ve en sık konulan tanı Crohn hastalığı (%15) idi. Görüntüleme tetkikleri normal olan 10 hastanın 4’ünün (%40) endoskopi bulguları anormal idi ve bu hastalar adenokarsinom (%10), polip (%10), anjiodisplazi (%10) ve Crohn hastalığı (%10) tanıları aldı. Endoskopi bulguları normal olan, fakat görüntüleme yöntemlerinde anormallik izlenen 1 (%4) hastaya lenfoma tanısı konuldu. Çift balonlu enteroskopi yapılma endikasyonu gastrointestinal kanama olan hastalarda, sıklıkla tümöral (%11) ve vasküler lezyonlar (%11) izlendi ve bu hastaların çoğuna kanser ve anjiodisplazi tanısı konuldu. Gastrointestinal kanama dışındaki nedenler ile çift balonlu enteroskopi yapılan hastalarda ise, en sık ülser, inflamasyon veya mukozal lezyon (%33) tespit edildi ve bu hastaların çoğuna Crohn hastalığı (%26) tanısı konuldu. Sonuç: Çift balonlu enteroskopi ince bağırsak hastalıklarının tanısının konulmasında ve terapötik işlemlerin yapılmasında etkili ve güvenli bir prosedürdür. Bununla birlikte, ince bağırsak hastalığı için çift balonlu enteroskopi yanında klinik ve radyolojik bulgularda dikkate alınmalıdır.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117225503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Aim: To report the efficacy and safety results of our initial experience with the endoscopic ultrasound-guided liver biopsy (EUS-LB). Materials and Method: Retrospective analysis of a prospectively maintained database in a tertiary care referral center. Consecutive patients who had EUS-LB for benign parenchymal diseases, using a 19 gauge fine needle with single-pass, three actuations, and wet suction technique between June 2022 and December 2022 were included. Patient demographics, procedure-related parameters, and the quality of specimens were investigated Results: The technical success was 100%. Of the 16 patients, four had a second procedure due to inadequate sampling. The median total sample length, the median number of pieces and the median length of the longest piece in fragmented samples, and the median number of complete portal tracts were 11mm (range, 0.2-2.5), 9.6 (range 0-20), 0.2mm (range 0.2-1.5) and 3.5 (range 0-19) respectively. None of the patients had any adverse events following the procedure. Conclusion: EUS-LB may be an alternative to other liver biopsy procedures but further studies are needed to determine the ideal needle type and technique.
{"title":"Endoscopic Ultrasound-guided Fine Needle Aspiration for Benign Liver Diseases: Single-center Experience","authors":"S. Tokmak, Sinem Coşkun Kantarcioğlu, S. Torun","doi":"10.17941/agd.1255462","DOIUrl":"https://doi.org/10.17941/agd.1255462","url":null,"abstract":"Background and Aim: To report the efficacy and safety results of our initial experience with the endoscopic ultrasound-guided liver biopsy (EUS-LB). \u0000 \u0000Materials and Method: Retrospective analysis of a prospectively maintained database in a tertiary care referral center. Consecutive patients who had EUS-LB for benign parenchymal diseases, using a 19 gauge fine needle with single-pass, three actuations, and wet suction technique between June 2022 and December 2022 were included. Patient demographics, procedure-related parameters, and the quality of specimens were investigated \u0000 \u0000Results: The technical success was 100%. Of the 16 patients, four had a second procedure due to inadequate sampling. The median total sample length, the median number of pieces and the median length of the longest piece in fragmented samples, and the median number of complete portal tracts were 11mm (range, 0.2-2.5), 9.6 (range 0-20), 0.2mm (range 0.2-1.5) and 3.5 (range 0-19) respectively. None of the patients had any adverse events following the procedure. \u0000 \u0000Conclusion: EUS-LB may be an alternative to other liver biopsy procedures but further studies are needed to determine the ideal needle type and technique.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116937151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giriş ve Amaç: Uzun süreli (on yıl) takip ettiğimiz aşırı demir yüklenmesi ve hemokromatozis olgularımız ışığında ortaya çıkan bulguları, tanı ve tedavideki zorlukları ve eksik yanlarımızı değerlendirmeyi amaçladık. Gereç ve Yöntem: 2012-2022 yılları arasında takip ettiğimiz, aşırı demir birikimi olan hastalar bilgisayar kayıtlarından retrospektif olarak değerlendirildi. Transferrin satürasyonu %45’ten yüksek ve serum ferritin düzeyleri erkeklerde 300 ng/dl, kadınlarda 200 ng/dl’den yüksek olan toplam 28 hasta saptandı. Hastalarda hemokromatozis için genetik testler yapıldı. Genetik testlerin pozitif veya negatif oluşuna göre hastalar analiz edildi. Bulgular: Toplam 28 hastadan 17’si H63D heterozigot, bir hasta H63D homozigot olarak bulundu. C282Y ve non-HFE hemokromatozise ait gen mutasyonu saptanmadı. On hastada herhangi bir mutasyon saptanmadı. Yirmi sekiz hastanın tümünde transferrin satürasyonu %45’ten büyük ve ferritin düzeyi 300 ng/dl’den yüksekti. H63D heterozigot bulunanların 10’unda (%58.8), mutasyon saptanmayanların 5’inde (%50) hepatosteatoz saptandı. Heterozigot pozitif olan grupta mutasyon saptanmayanlara göre demir birikimi biraz daha yüksekti (ortalama ferritin düzeyi 1478 ng/dl’ye 827ng/dl). Hastaların hepsinde hepatit B yüzey antijeni negatifti. Bir hastada anti-hepatit C virüsü pozitifti. Magnetik rezonans çekilen 16 hastada demir yüklenmesi düşündüren sinyal kaybı bulgusu bildirilmedi. Still hastalığına ilişkin ateş, artralji gibi bir bulgu saptanmadı. Sonuçlar: Aşırı demir yüklenmesi sık karşılaşılan bir durum olmamakla birlikte saptandığında ayırıcı tanısı zordur. Herediter hemokromatozis ve non-HFE hemokromatozis bunların çok az bir kısmını oluşturur. Bulgularımız aşırı demir birikmesinin en sık sebeplerinden birinin non-alkolik yağlı karaciğer hastalığına bağlı olduğunu göstermektedir.
{"title":"Aşırı demir yüklenmesi ve hemokromatozis","authors":"Halil Atasoy, Gökhan Aydin","doi":"10.17941/agd.1338597","DOIUrl":"https://doi.org/10.17941/agd.1338597","url":null,"abstract":"Giriş ve Amaç: Uzun süreli (on yıl) takip ettiğimiz aşırı demir yüklenmesi ve hemokromatozis olgularımız ışığında ortaya çıkan bulguları, tanı ve tedavideki zorlukları ve eksik yanlarımızı değerlendirmeyi amaçladık. Gereç ve Yöntem: 2012-2022 yılları arasında takip ettiğimiz, aşırı demir birikimi olan hastalar bilgisayar kayıtlarından retrospektif olarak değerlendirildi. Transferrin satürasyonu %45’ten yüksek ve serum ferritin düzeyleri erkeklerde 300 ng/dl, kadınlarda 200 ng/dl’den yüksek olan toplam 28 hasta saptandı. Hastalarda hemokromatozis için genetik testler yapıldı. Genetik testlerin pozitif veya negatif oluşuna göre hastalar analiz edildi. Bulgular: Toplam 28 hastadan 17’si H63D heterozigot, bir hasta H63D homozigot olarak bulundu. C282Y ve non-HFE hemokromatozise ait gen mutasyonu saptanmadı. On hastada herhangi bir mutasyon saptanmadı. Yirmi sekiz hastanın tümünde transferrin satürasyonu %45’ten büyük ve ferritin düzeyi 300 ng/dl’den yüksekti. H63D heterozigot bulunanların 10’unda (%58.8), mutasyon saptanmayanların 5’inde (%50) hepatosteatoz saptandı. Heterozigot pozitif olan grupta mutasyon saptanmayanlara göre demir birikimi biraz daha yüksekti (ortalama ferritin düzeyi 1478 ng/dl’ye 827ng/dl). Hastaların hepsinde hepatit B yüzey antijeni negatifti. Bir hastada anti-hepatit C virüsü pozitifti. Magnetik rezonans çekilen 16 hastada demir yüklenmesi düşündüren sinyal kaybı bulgusu bildirilmedi. Still hastalığına ilişkin ateş, artralji gibi bir bulgu saptanmadı. Sonuçlar: Aşırı demir yüklenmesi sık karşılaşılan bir durum olmamakla birlikte saptandığında ayırıcı tanısı zordur. Herediter hemokromatozis ve non-HFE hemokromatozis bunların çok az bir kısmını oluşturur. Bulgularımız aşırı demir birikmesinin en sık sebeplerinden birinin non-alkolik yağlı karaciğer hastalığına bağlı olduğunu göstermektedir.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130786054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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