Gastroenterologia y hepatologia最新文献

英文中文

Clinical, endoscopic and histological characteristics of Chlamydia trachomatis proctitis in males 男性沙眼衣原体直肠炎的临床、内镜及组织学特征。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2026-01-01 DOI: 10.1016/j.gastrohep.2025.502558

Marta Teller , Antonio Giordano , Carlos González-Muñoza , Jordi Gordillo , Federico Bertoletti , Fernando Sánchez-Reus , Esther Garcia-Planella

Objective

Chlamydia trachomatis is a prevalent cause of infectious proctitis, often misdiagnosed as cancer or inflammatory bowel disease (IBD). This study aims to describe the main clinical symptoms, together with endoscopic and histopathological characteristics of C. trachomatis proctitis in the general population.

Patients and methods

A retrospective observational study was conducted at a single institution, identifying all cases of proctitis due to C. trachomatis infection, detected by real-time PCR in rectal biopsy or anal smear, with endoscopic assessment.

Results

A total of 28 male patients were included (median age 37, IQR 31–48). Among them, 20 patients reported having sex with males. Concomitant infections included HIV (n = 10), Neisseria gonorrhoea (n = 4), and Treponema pallidum (n = 2). A history of sexually transmitted diseases was reported by 18 patients (64%). The main clinical symptoms were rectal bleeding (79%) and diarrhoea (43%). The main endoscopic findings were rectal erythema (71%) and ulcers (57%), with rectal (89%) and sigmoid inflammation (11%). In 5 cases (18%), a single isolated deep rectal ulcer was the only finding. In 16 cases (57.1%), neoplasia, IBD or fissure was suspected according to endoscopy. Histological findings included mixed inflammatory infiltrate of lamina propria (95%), cryptitis (54%), and crypt abscesses (32%).

Conclusions

Endoscopically detected C. trachomatis proctitis in men presents with worrisome symptoms and nonspecific rectal ulcers, with chronic inflammation histology. This generates doubts about differential diagnosis with IBD and rectal cancer.

目的：沙眼衣原体是感染性直肠炎的常见病因，常被误诊为癌症或炎症性肠病（IBD）。本研究旨在描述普通人群中沙眼衣原体直肠炎的主要临床症状，以及内镜和组织病理学特征。患者和方法：在单一机构进行回顾性观察性研究，确定所有由沙眼衣原体感染引起的直肠炎病例，通过直肠活检或肛门涂片实时PCR检测，并进行内镜评估。结果：共纳入28例男性患者（中位年龄37岁，IQR 31-48）。其中，20名患者报告与男性发生过性行为。伴发感染包括HIV（10例）、淋病奈瑟菌（4例）和梅毒螺旋体（2例）。18例（64%）有性传播疾病史。主要临床症状为直肠出血（79%）和腹泻（43%）。内镜下主要表现为直肠红斑（71%）和溃疡（57%），直肠（89%）和乙状结肠炎症（11%）。在5例（18%）中，唯一的发现是单一的孤立的直肠深部溃疡。16例（57.1%）经内镜检查怀疑为肿瘤、IBD或裂隙。组织学表现包括固有层混合性炎症浸润（95%）、隐窝炎（54%）和隐窝脓肿（32%）。结论：内镜下发现的男性沙眼衣原体直肠炎表现为令人担忧的症状和非特异性直肠溃疡，具有慢性炎症组织学。这就对IBD和直肠癌的鉴别诊断产生了疑问。

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引用次数: 0

Hemorragia digestiva alta secundaria a brunnerioma duodenal 布伦纳腺错构瘤导致上消化道出血。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2026-01-01 DOI: 10.1016/j.gastrohep.2025.502519

Ana Sánchez Martínez , Elena Romera Barba , Alberto Sánchez Espinosa

引用次数: 0

Epidemiology and healthcare resource utilization in inflammatory bowel disease in Colombia between 2017 and 2021: A retrospective claims database study 2017-2021年哥伦比亚炎症性肠病的流行病学和医疗资源利用：回顾性索赔数据库研究

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2026-01-01 DOI: 10.1016/j.gastrohep.2025.502532

Fabián Juliao-Baños , Viviana Parra-Izquierdo , Tatiana Pacheco-Páez , Janeth Tatiana Acosta Leaño

Background and aims

The incidence and prevalence of inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are increasing across Latin America. IBD has an important impact on patients’ quality of life and is associated with significant healthcare resource utilization (HCRU). This study aimed to describe the more recent epidemiological characteristics and HCRU patterns of IBD in Colombia.

Methods

Retrospective study using real-world data from the national claims database SISPRO (Sistema de Información para la Protección Social) between 2017 and 2021. The data considered were sociodemographic (sex and age), epidemiological (incidence, prevalence, and mortality), and HCRU data.

Results

We identified 54,961 cases of prevalent ulcerative colitis (UC) and 13,136 cases of Crohn's disease (CD). Between 2017 and 2019, the incidence rates for UC increased from 3.82 to 5.18 per 100,000 individuals, while the incidence for CD rose from 0.48 to 0.83 per 100,000. The prevalence of these conditions reached its highest point in 2019, with UC at 48.65 and CD at 15.41 per 100,000 population. Mortality data indicated 259 deaths registered with UC and 77 with CD. The utilization of biologic therapies saw a significant rise from 2020 to 2021, particularly with anti-TNF agents being the most frequently prescribed. The patterns observed in outpatient visits and hospital admissions followed similar trajectories, exhibiting a downturn during the COVID-19 pandemic.

Conclusions

This study examined the epidemiology, HCRU, and costs of IBD in Colombia using SISPRO data. Despite a decrease during the COVID-19 pandemic, the incidence and prevalence of IBD have increased over time, accompanied by elevated HCRU and medication costs. These insights could contribute to informed decision-making and resource allocation for enhanced patient care in Colombia.

背景和目的：炎症性肠病（IBD）的发病率和患病率，包括克罗恩病（CD）和溃疡性结肠炎（UC），在拉丁美洲正在增加。IBD对患者的生活质量有重要影响，并与显著的医疗资源利用率（HCRU）相关。本研究旨在描述哥伦比亚IBD的最新流行病学特征和HCRU模式。方法：回顾性研究使用国家索赔数据库SISPRO (Sistema de Información para la Protección Social) 2017年至2021年的真实数据。考虑的数据包括社会人口学（性别和年龄）、流行病学（发病率、患病率和死亡率）和HCRU数据。结果：我们确定了54,961例普遍溃疡性结肠炎（UC）和13,136例克罗恩病（CD）。在2017年至2019年期间，UC的发病率从每10万人3.82例上升到5.18例，而CD的发病率从每10万人0.48例上升到0.83例。这些疾病的患病率在2019年达到最高点，UC为每10万人48.65人，CD为15.41人。死亡率数据显示，UC登记的死亡人数为259人，CD登记的死亡人数为77人。从2020年到2021年，生物疗法的使用率显著上升，特别是抗肿瘤坏死因子药物是最常用的处方。在门诊就诊和住院中观察到的模式遵循类似的轨迹，在COVID-19大流行期间表现出低迷。结论：本研究使用SISPRO数据调查了哥伦比亚IBD的流行病学、HCRU和费用。尽管在2019冠状病毒病大流行期间有所下降，但随着时间的推移，IBD的发病率和流行率有所增加，同时HCRU和药物费用也有所上升。这些见解有助于在哥伦比亚作出明智的决策和分配资源，以加强对病人的护理。

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引用次数: 0

Clinical outcomes in the implementation of peroral endoscopic myotomy (POEM): Results from the Spanish multicenter registry 实施经口内窥镜肌切开术（POEM）的临床结果：来自西班牙多中心登记的结果。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2026-01-01 DOI: 10.1016/j.gastrohep.2025.502527

Fermín Estremera-Arevalo , Silvia Bravo-Meléndez , Gonzalo Hijos-Mallada , Carlos Guarner-Argente , Marianette Murzi , Enrique Rodríguez-Santiago , Alberto Herreros de Tejada , Hugo Uchima-Koecklin , Pablo Miranda-García , David Barquero-Declara , Jose María Riesco-López , Pedro de María-Pallarés , Mª Gloria Fernández-Esparrach , Andrés Sánchez-Yagüe , Irene Aresté-Anduaga , Gonzalo Gonzalez-Gete , Carlos Teruel Sanchez-Vegazo , Beatriz Peñas-García , Sofía Parejo-Carbonell , Alba Martínez-Sánchez , Eduardo Albeniz

Objective

Peroral endoscopic myotomy (POEM) has emerged as a prominent endoscopic treatment for achalasia and other esophageal motility disorders (EMD). The objective of this study is to evaluate its clinical efficacy and safety after its implementation in Spain.

Patients and methods

This is a multicenter registry conducted across 13 hospitals in Spain. Symptomatic patients undergoing POEM for any EMD were recruited between June 2016 and February 2023. Baseline characteristics, procedural details and outcomes related to efficacy and safety during short and long-term follow-up were analyzed.

Results

A total of 441 patients were enrolled, with type II achalasia representing the most common diagnosis (62.1%). POEM was the primary treatment in 277 patients (62.8%). Clinical success data were available for 396 patients, with a success rate of 94.4% at the last available follow-up (2 years in 117 patients, 1 year in 140, <1 year in 139). A higher baseline Eckardt score was an independent risk factor for clinical failure in the long-term follow-up (p = 0.024). Symptomatic reflux occurred in 4.7% of the patients, with a significant esophagitis rate of 11.3%. Complication incidence was 9.3% (41/441), including 14 (3.2%) severe events. Older age (p = 0.025) and total procedure duration (p = 0.036) were independent risk factors for complications, while mucosal injury was found to be a predictor of severe complications (p = 0.027).

Conclusions

These findings confirm the clinical efficacy and safety during the implementation phase of POEM for all EMD in Spain.

目的：经口内镜下肌切开术（POEM）已成为贲门失弛缓症和其他食管运动障碍（EMD）的重要内镜治疗方法。本研究的目的是评估其在西班牙实施后的临床疗效和安全性。患者和方法：这是一项在西班牙13家医院进行的多中心登记。在2016年6月至2023年2月期间招募了接受POEM治疗任何EMD的有症状患者。在短期和长期随访期间分析基线特征、程序细节和与疗效和安全性相关的结果。结果：共纳入441例患者，II型失弛缓症是最常见的诊断（62.1%）。POEM是277例（62.8%）患者的主要治疗方法。396例患者获得了临床成功数据，在最后一次随访中成功率为94.4%（117例2年，140例1年）。结论：这些发现证实了POEM在西班牙所有EMD实施阶段的临床疗效和安全性。

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引用次数: 0

Translation and psychometric evaluation of the Spanish version of the Inflammatory Bowel Disease Knowledge (IBD-KNOW) questionnaire 西班牙语版炎症性肠病知识（ibd-know）问卷的翻译和心理测量评估。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2026-01-01 DOI: 10.1016/j.gastrohep.2025.502576

Pilar Corsino Roche , Josep-Oriol Casanovas-Marsal , Santiago García López , Raquel Vicente Lidón , Eva Sierra Moros , Sonia Gallego Montañés , Diego Casas Deza , Laura Vicente Manso , Laura Lafarga-Molina

Objective

To translate, culturally adapt, and validate the Inflammatory Bowel Disease Knowledge questionnaire in adult Spanish-speaking patients with IBD.

Patients and methods

A cross-sectional translation and linguistic validation study was conducted with 30 participants aged > 18 years with Inflammatory Bowel Disease at the Miguel Servet University Hospital (Zaragoza, Spain). The IBD-KNOW questionnaire was translated and culturally adapted following ISPOR guidelines. Content validity was assessed by a panel of experts using Aiken's V coefficient. Internal consistency was evaluated using Cronbach's alpha, and test–retest reliability was assessed with the intraclass correlation coefficient (ICC). Descriptive analyses and bivariate tests were used to evaluate sociodemographic and clinical variables, as well as associations with IBD knowledge.

Results

The study assessed 30 adults (50% female) with an average age of 44.21 ± 15.05 years; mean age at diagnosis 29.24 ± 11.42 years and mean disease duration 14.97 ± 8.70 years. The Spanish version of the IBD-KNOW demonstrated good internal consistency (Cronbach's α = 0.74) and strong test–retest reliability (ICC = 0.80; 95% CI: 0.62–0.89). No statistically significant differences were found between the test and retest scores (p = 0.39) or completion times (p = 0.736). The mean questionnaire score was 5.87 ± 1.53 out of 10.

Conclusions

The Spanish version of the IBD-KNOW questionnaire is a valid, reliable, and culturally appropriate instrument for assessing disease-related knowledge in Spanish-speaking IBD patients. Its use in clinical settings can support the identification of educational needs and the design of targeted interventions aimed at improving patient engagement and health outcomes.

目的：翻译、文化适应和验证西班牙语IBD成年患者炎症性肠病知识问卷。患者和方法：在Miguel Servet大学医院（Zaragoza, Spain）对30名年龄在bb0 - 18岁的炎症性肠病患者进行了一项横断面翻译和语言验证研究。IBD-KNOW问卷是按照ISPOR指南进行翻译和文化调整的。内容效度由专家小组使用艾肯的V系数进行评估。采用Cronbach’s alpha评价内部一致性，采用类内相关系数（ICC）评价重测信度。描述性分析和双变量检验用于评估社会人口学和临床变量，以及与IBD知识的关联。结果：共纳入成人30例（女性50%），平均年龄44.21±15.05岁；平均诊断年龄29.24±11.42岁，平均病程14.97±8.70年。西班牙语版IBD-KNOW具有良好的内部一致性（Cronbach's α = 0.74）和较强的重测信度（ICC = 0.80; 95% CI: 0.62-0.89）。测试和重测得分（p = 0.39）或完成时间（p = 0.736）之间无统计学差异。问卷平均得分为5.87±1.53分（满分24分）。结论：西班牙语版IBD- know问卷是评估西班牙语IBD患者疾病相关知识的有效、可靠和文化适宜的工具。在临床环境中使用它可以支持确定教育需求和设计有针对性的干预措施，以改善患者的参与和健康结果。

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引用次数: 0

Divertículo duodenal intraluminal: una causa inusual de hemorragia digestiva alta Windsock十二指肠憩室：上消化道出血的罕见原因。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2026-01-01 DOI: 10.1016/j.gastrohep.2025.502497

Sara Sánchez Moreno, Ana Plaza Fernández, Francisca Anguita Montes

引用次数: 0

Distrofia quística duodenal con diagnóstico final de adenocarcinoma de páncreas: ¿relación directa o hallazgo casual? 十二指肠囊性营养不良最终诊断为胰腺腺癌：直接关系还是偶然发现？

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2026-01-01 DOI: 10.1016/j.gastrohep.2025.502534

Pablo Fernández Rodriguez , Lidia Castillo Gázquez , Tomás Álvarez Malé , Mirella Jiménez Gómez

引用次数: 0

Effectiveness of Sofosbuvir/Velpatasvir in a patient with ultra-short bowel syndrome and hepatitis C virus infection: A case report. 索非布韦/维帕他韦治疗超短肠综合征合并丙型肝炎病毒感染1例

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2025-12-30 DOI: 10.1016/j.gastrohep.2025.502649

Cristina Olmedo Moreno, Francisco López Romero-Salazar, Raquel Muñoz Gómez, María Maíz Jiménez, Carmelo Loinaz Segurola, María Cámara Jurado, Yago González Lama, Inmaculada Fernández Vázquez

引用次数: 0

Rationale and design of the NATURCEL registry: Study of the NATURal history and the epidemiological, clinical, diagnostic and therapeutic aspects of CoELiac disease and noncoeliac enteropathies. NATURCEL登记的基本原理和设计：研究乳糜泻和非乳糜泻肠病的自然史和流行病学、临床、诊断和治疗方面。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2025-12-24 DOI: 10.1016/j.gastrohep.2025.502648

Albert Martín-Cardona, Gemma Ibáñez-Sanz, Emma Sudrià-Lopez, Beatriz Arau, Sabela Carballal, Roger Garcia-Puig, Anna Carrasco, Ivan Villar-Balboa, Montse Ibarra, Carme Ferrer, Mireia Fonolleda, Montserrat Planella, Azucena Salas, Sebastián Videla, Carme Loras, Maria Esteve

Coeliac disease is a chronic immune-mediated enteropathy triggered by gluten intake, which affects the small intestine in genetically susceptible individuals (HLA-DQ2 and/or HLA-DQ8). This disease, which occurs in both children and adults, is among the most common genetically determined disorders in Western countries. It is characterized by the presence of very varied and often nonspecific clinical manifestations (primarily digestive symptoms and signs of intestinal malabsorption), as well as the presence of specific antibodies (tissue transglutaminase and endomysium) and enteropathy. Currently, the only treatment for coeliac disease is a strict gluten-free diet for life. The main objective of the NATURCEL (NATURal history, epidemiological, clinical, diagnostic and therapeutic aspects of CoELiac disease and noncoeliac enteropathies) registry is to collect selected variables on different aspects of the disease (epidemiological, clinical, genetic, immunological, etc.) for a subsequent shared analysis for scientific and translational purposes.

乳糜泻是一种由麸质摄入引发的慢性免疫介导的肠病，它影响遗传易感个体（HLA-DQ2和/或HLA-DQ8）的小肠。这种疾病在儿童和成人中都有发生，是西方国家最常见的由基因决定的疾病之一。它的特点是存在非常多样且通常是非特异性的临床表现（主要是消化症状和肠道吸收不良的迹象），以及存在特异性抗体（组织转谷氨酰胺酶和肌内膜）和肠病。目前，治疗乳糜泻的唯一方法是终生严格的无麸质饮食。NATURCEL（乳糜泻和非乳糜泻肠道病的自然史、流行病学、临床、诊断和治疗方面）登记的主要目的是收集有关该疾病不同方面（流行病学、临床、遗传、免疫学等）的选定变量，以便随后为科学和转化目的进行共享分析。

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引用次数: 0

Management of refractory ulcerative proctitis. 难治性溃疡性直肠炎的治疗。

IF 1.9 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterologia y hepatologia

Pub Date : 2025-12-20 DOI: 10.1016/j.gastrohep.2025.502646

Manuel Barreiro-de Acosta, Francisco Mesonero, Rocío Ferreiro-Iglesias, Santiago García-López, Mariam Aguas Peris, Mónica Sierra Ausín, Noelia Cano Sanz, Antonio Valdivia Martínez, Ana Cábez, Susan Ramírez, Daniel Ginard

Objective: Ulcerative proctitis (UP) usually presents a milder course, but some patients develop significant symptom burden, severe forms, or refractory UP (RUP). Our objective was to characterise RUP and generate recommendations for daily practice.

Methods: A systematic review (SR) was conducted to analyze epidemiological, clinical, and pharmacological treatment aspects of RUP. The results were discussed in a nominal focus group meeting composed of seven gastroenterologists specialized in the management of inflammatory bowel disease, a nurse, and a patient. Several statements on the management of PU were proposed and voted to achieve agreement.

Results: The SR included 43 articles of low to moderate quality. Nearly 30% of patients presented RUP, and the impact of the disease on their quality of life was highly significant. Different gaps of knowledge related to the clinical characteristics and course of the disease, efficacy, safety, and selection of pharmacological treatments were identified. The experts proposed 13 practical statements that reached the established level of agreement. These address the diagnosis of UP and RUP, their therapeutic goals and treatment selection, monitoring, treatment response, and the role of the nurse.

Conclusions: RUP is common and can have a significant impact on patients. More research is needed to characterize RUP and the long-term efficacy of available treatments. The proposed statements aim to address the knowledge gaps related to RUP.

目的：溃疡性直肠炎（UP）通常表现为较轻的病程，但一些患者出现明显的症状负担，严重的形式，或难治性UP （RUP）。我们的目标是描述RUP并为日常实践生成建议。方法：系统的回顾（SR）被用于分析RUP的流行病学、临床和药理学治疗方面。研究结果在一个名义上的焦点小组会议上进行了讨论，该小组由七名专门从事炎症性肠病管理的胃肠病学家、一名护士和一名患者组成。提出了几项关于PU管理的声明，并进行表决以达成协议。结果：共纳入中低质量文献43篇。近30%的患者出现RUP，疾病对其生活质量的影响是非常显著的。发现了与临床特征、病程、疗效、安全性和药物治疗选择相关的不同知识缺口。专家们提出了13项实际声明，达到了既定的一致水平。这些讨论了UP和RUP的诊断，它们的治疗目标和治疗选择，监测，治疗反应，以及护士的角色。结论：RUP是常见的，并且对患者有显著的影响。需要更多的研究来描述RUP的特性以及可用的治疗方法的长期功效。建议的陈述旨在解决与RUP相关的知识差距。

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