1. Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F. World Health Organization classification of tumours of soft tissue and bone. Fourth Edition. Vol 5. Lyon: IARC Press; 2013. pp. 230–231 2. Hornick JL, Fletcher CD. PEComa: What do we know so far? Histopathology. 2006;48:75–82 3. Folpe AL, Goodman ZD, Ishak KG, Paulino AF, Taboada EM, Meehan SA, et al. Clear cell myomelanocytic tumor of the falciform ligament/ligamentum teres: a novel member of the perivascular epithelioid clear cell family of tumors with a predilection for children and young adults. Am J Surg Pathol. 2000;24:1239–1246 4. Tsui WM, Colombari R, Portmann BC, Bonetti F, Thung SN, Ferrell LD, Nakanuma Y, Snover DC, Bioulac-Sage P, Dhillon AP. Hepatic angiomyolipoma: A clinicopathologic study of 30 cases and delineation of unusual morphologic variants. Am J Surg Pathol. 1999;23:34–48 5. Ooi SM, Vivian JB, Cohen RJ. The use of the Ki-67 marker in the pathological diagnosis of the epithelioid variant of renal angiomyolipoma. Int Urol Nephrol. 2009;41:559– 565. 6. Martignoni G, Pea M, Reghellin D, Zamboni G, Bonetti F. PEComas: The past, the present and the future. Virchows Arch. 2008;452:119–132. doi: 10.1007/s00428-007-0509-1 7. Brimo F, Robinson B, Guo C, Zhou M, Latour M, Epstein JI. Renal epithelioid angiomyolipoma with atypia: a series of 40 cases with emphasis on clinicopathologic prognostic indicators of malignancy. Am J Surg Pathol. 2010;34:715– 722. 8. Deng YF, Lin Q, Zhang SH, Ling YM, He JK, Chen XF. Malignant angiomyolipoma in the liver: a case report with pathological and molecular analysis. Pathol Res Pract. 2008;204:911–918 9. Xu H, Wang H, Zhang X, Li G. [Hepatic epithelioid angiomyolipoma: a clinicopathologic analysis of 25 cases] Zhonghua Bing Li Xue Zazhi. 2014;43:685–689.
{"title":"Secondary CBD Stone due to Curry Leaf Stems: A Case Report and Review of Literature","authors":"A. Teja, A. Pujahari","doi":"10.7869/TG.588","DOIUrl":"https://doi.org/10.7869/TG.588","url":null,"abstract":"1. Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F. World Health Organization classification of tumours of soft tissue and bone. Fourth Edition. Vol 5. Lyon: IARC Press; 2013. pp. 230–231 2. Hornick JL, Fletcher CD. PEComa: What do we know so far? Histopathology. 2006;48:75–82 3. Folpe AL, Goodman ZD, Ishak KG, Paulino AF, Taboada EM, Meehan SA, et al. Clear cell myomelanocytic tumor of the falciform ligament/ligamentum teres: a novel member of the perivascular epithelioid clear cell family of tumors with a predilection for children and young adults. Am J Surg Pathol. 2000;24:1239–1246 4. Tsui WM, Colombari R, Portmann BC, Bonetti F, Thung SN, Ferrell LD, Nakanuma Y, Snover DC, Bioulac-Sage P, Dhillon AP. Hepatic angiomyolipoma: A clinicopathologic study of 30 cases and delineation of unusual morphologic variants. Am J Surg Pathol. 1999;23:34–48 5. Ooi SM, Vivian JB, Cohen RJ. The use of the Ki-67 marker in the pathological diagnosis of the epithelioid variant of renal angiomyolipoma. Int Urol Nephrol. 2009;41:559– 565. 6. Martignoni G, Pea M, Reghellin D, Zamboni G, Bonetti F. PEComas: The past, the present and the future. Virchows Arch. 2008;452:119–132. doi: 10.1007/s00428-007-0509-1 7. Brimo F, Robinson B, Guo C, Zhou M, Latour M, Epstein JI. Renal epithelioid angiomyolipoma with atypia: a series of 40 cases with emphasis on clinicopathologic prognostic indicators of malignancy. Am J Surg Pathol. 2010;34:715– 722. 8. Deng YF, Lin Q, Zhang SH, Ling YM, He JK, Chen XF. Malignant angiomyolipoma in the liver: a case report with pathological and molecular analysis. Pathol Res Pract. 2008;204:911–918 9. Xu H, Wang H, Zhang X, Li G. [Hepatic epithelioid angiomyolipoma: a clinicopathologic analysis of 25 cases] Zhonghua Bing Li Xue Zazhi. 2014;43:685–689.","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":"22 1","pages":"91-93"},"PeriodicalIF":0.0,"publicationDate":"2020-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89715165","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}
R. Yadav, S. Gamanagatti, Atin Kumar, Subodh Kumar
Corresponding Author: Dr Shivanand Gamanagatti Email: shiv223@gmail.com Acute Severe Pancreatitis and Bilateral Renal Cortical Necrosis The diagnosis can be challenging since it may not be possible to distinguish AFNAC from ulcerative colitis or Crohns’ disease since they can have a similar presentation.1-3 Clinical symptoms and signs, laboratory investigations, and radiology remain inconclusive in distinguishing between them. The presence of trophozoites, especially if showing erythrophagocytosis (ingested red blood cells in the cytoplasm) in fresh stool samples of symptomatic patients, was typically considered diagnostic; recently, erythrophagocytosis has been reported in non-pathogenic trophozoites too. Serological tests for amoebiasis are of doubtful value in endemic areas as they cannot distinguish between prior and present infection; antigen detection in stool and molecular techniques using polymerase chain reaction are highly sensitive, but not easily accessible. In the absence of these tests, the only means of definitely establishing the diagnosis may be a demonstration of trophozoites of E. histolytica on histopathology.4 Surgery should be expedited in AFNAC.1-3 Bowel involvement dictates the extent of the colonic resection; primary anastomosis is usually precluded since the colon is very friable, and it is safer to resect and exteriorize the proximal and distal bowel to be restored at a later date.1-3,5 Amoebicidal therapy (metronidazole followed by luminal agents such as diloxanide furoate) should be given in suspected cases, and continued if the diagnosis is confirmed.
{"title":"Acute Severe Pancreatitis and Bilateral Renal Cortical Necrosis","authors":"R. Yadav, S. Gamanagatti, Atin Kumar, Subodh Kumar","doi":"10.7869/TG.586","DOIUrl":"https://doi.org/10.7869/TG.586","url":null,"abstract":"Corresponding Author: Dr Shivanand Gamanagatti Email: shiv223@gmail.com Acute Severe Pancreatitis and Bilateral Renal Cortical Necrosis The diagnosis can be challenging since it may not be possible to distinguish AFNAC from ulcerative colitis or Crohns’ disease since they can have a similar presentation.1-3 Clinical symptoms and signs, laboratory investigations, and radiology remain inconclusive in distinguishing between them. The presence of trophozoites, especially if showing erythrophagocytosis (ingested red blood cells in the cytoplasm) in fresh stool samples of symptomatic patients, was typically considered diagnostic; recently, erythrophagocytosis has been reported in non-pathogenic trophozoites too. Serological tests for amoebiasis are of doubtful value in endemic areas as they cannot distinguish between prior and present infection; antigen detection in stool and molecular techniques using polymerase chain reaction are highly sensitive, but not easily accessible. In the absence of these tests, the only means of definitely establishing the diagnosis may be a demonstration of trophozoites of E. histolytica on histopathology.4 Surgery should be expedited in AFNAC.1-3 Bowel involvement dictates the extent of the colonic resection; primary anastomosis is usually precluded since the colon is very friable, and it is safer to resect and exteriorize the proximal and distal bowel to be restored at a later date.1-3,5 Amoebicidal therapy (metronidazole followed by luminal agents such as diloxanide furoate) should be given in suspected cases, and continued if the diagnosis is confirmed.","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":"19 1","pages":"87-89"},"PeriodicalIF":0.0,"publicationDate":"2020-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82539973","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}
Penetrating rectal injuries in civilian surgical practice are mostly due to gun-shot injuries or stab injuries in buttock area1. Treatment algorithm of these penetrating injuries depends upon whether its a gun-shot or stab wound. Irrespective, the management of these injuries is challenging and depends upon associated internal injuries. Fundamental management principles of rectal injury secondary to stab wound include direct primary closure, fecal diversion, presacral drainage or distal rectal washout.2 We report a case of stab injury to the natal cleft region with the rectal injury which was successfully managed endoscopically by using over-the-scope-clip (OTSC).
{"title":"Successful Closure of Penetrating Rectal Injury Using Flexible Endoscopic Over-the-Scope-Clip (OTSC)","authors":"A. Jain, Sudesh Sharda, A. Joshi, Suchita Jain","doi":"10.7869/TG.584","DOIUrl":"https://doi.org/10.7869/TG.584","url":null,"abstract":"Penetrating rectal injuries in civilian surgical practice are mostly due to gun-shot injuries or stab injuries in buttock area1. Treatment algorithm of these penetrating injuries depends upon whether its a gun-shot or stab wound. Irrespective, the management of these injuries is challenging and depends upon associated internal injuries. Fundamental management principles of rectal injury secondary to stab wound include direct primary closure, fecal diversion, presacral drainage or distal rectal washout.2 We report a case of stab injury to the natal cleft region with the rectal injury which was successfully managed endoscopically by using over-the-scope-clip (OTSC).","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":"37 1","pages":"84-85"},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89340428","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}
A. Javed, G. Agarwal, Aravinda Ps, J. Manipadam, S. Puri, A. Agarwal
Background : Hydatid cyst of the pancreas is rare and differentiating from more common cystic lesions of the pancreas is difficult preoperatively. Patients and Methods : Retrospective analysis of consecutive patients with intra-abdominal hydatid disease in our center from January 2000 to December 2017. We identified six patients with pancreatic hydatid cyst during the study period, which made our study group. Results: Of 310 patients with intra-abdominal hydatid cysts, only 6 (1.9%) patients had pancreatic hydatid cysts. The age ranged from 14 to 48 years, and all six were female. Pain was the predominant symptom in all patients, associated with abdominal mass in four patients, nausea in 2 patients, and fever in 1 patient. Intracystic bleeding complicated one patient. Cysts were isolated to the pancreas in all cases, being located in the head of the pancreas in one patient, body in one patient, tail in two patients, body and tail of the pancreas in two patients. The average size of the cyst was 8.8 cm (range: 5 to 14 cm). Hydatid serology was positive in three patients; therefore, accurate preoperative diagnosis was established in only three patients (50%). Besides albendazole therapy, four patients underwent open surgery, and two underwent laparoscopic surgery. Surgical procedures included emergency distal pancreatico-splenectomy, cysto-pericystectomy, deroofing with and without Roux-en-Y cysto-jejunostomy, and distal pancreatectomy. The patients did well with a mean follow-up of 41.5 months, without recurrence. Conclusion : Primary pancreatic hydatid cysts are rare, difficult to diagnose, and timely intervention avoids life-threatening complications. Cyst-enteric anastomosis in patients undergoing deroofing may prevent pancreatic fistula, and laparoscopic surgery is feasible and safe.
{"title":"Hydatid Cyst of the Pancreas: A Diagnostic Dilemma","authors":"A. Javed, G. Agarwal, Aravinda Ps, J. Manipadam, S. Puri, A. Agarwal","doi":"10.7869/TG.582","DOIUrl":"https://doi.org/10.7869/TG.582","url":null,"abstract":"Background : Hydatid cyst of the pancreas is rare and differentiating from more common cystic lesions of the pancreas is difficult preoperatively. Patients and Methods : Retrospective analysis of consecutive patients with intra-abdominal hydatid disease in our center from January 2000 to December 2017. We identified six patients with pancreatic hydatid cyst during the study period, which made our study group. Results: Of 310 patients with intra-abdominal hydatid cysts, only 6 (1.9%) patients had pancreatic hydatid cysts. The age ranged from 14 to 48 years, and all six were female. Pain was the predominant symptom in all patients, associated with abdominal mass in four patients, nausea in 2 patients, and fever in 1 patient. Intracystic bleeding complicated one patient. Cysts were isolated to the pancreas in all cases, being located in the head of the pancreas in one patient, body in one patient, tail in two patients, body and tail of the pancreas in two patients. The average size of the cyst was 8.8 cm (range: 5 to 14 cm). Hydatid serology was positive in three patients; therefore, accurate preoperative diagnosis was established in only three patients (50%). Besides albendazole therapy, four patients underwent open surgery, and two underwent laparoscopic surgery. Surgical procedures included emergency distal pancreatico-splenectomy, cysto-pericystectomy, deroofing with and without Roux-en-Y cysto-jejunostomy, and distal pancreatectomy. The patients did well with a mean follow-up of 41.5 months, without recurrence. Conclusion : Primary pancreatic hydatid cysts are rare, difficult to diagnose, and timely intervention avoids life-threatening complications. Cyst-enteric anastomosis in patients undergoing deroofing may prevent pancreatic fistula, and laparoscopic surgery is feasible and safe.","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":"9 1","pages":"73-81"},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90758736","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}
Magnus Mansard, R. Siddachari, Goutham Kumar, N. Subramanian, A. Olithselvan
Background : Liver transplants in India are mostly done in a few large volume centers. There are many small volume centers which use the expertise and support from these large volume centers to carry out liver transplantations. The effectiveness of this model where a core large volume center supports the smaller volume satellite centers has not been evaluated before. Aim : To assess the outcomes of patients transplanted atsatellite centres and monitored remotely and compare them with those transplanted in the core center and managed by an in-house team. Results : The recipients in the satellite centers were younger than those in the core hospital. The other parameters were comparable. The donors were younger in the satellite hospitals than those in the core hospital.The incidence of early graft dysfunction was lesser in the peripheral hospitals than in the core hospital (5 [10.20%] vs 11 [35.48%],p = 0.009). The length of postoperative hospital stay was also lesser among patients operated in the satellite centers (15.96 ± 6.75 vs 20.59 ± 10.14, p = 0.018). Conclusion : This core-satellites model has been shown to be an effective model in the performance of liver transplantations at multiple centers with equivalent outcomes.
背景:印度的肝移植大多是在几个大容量的中心进行的。有许多小容量中心利用这些大容量中心的专业知识和支持来进行肝移植。该模型的有效性，其中一个核心大体积中心支持较小体积的卫星中心，以前没有评估。目的:评估在卫星中心移植并远程监测的患者的预后，并将其与在核心中心移植并由内部团队管理的患者进行比较。结果:卫星中心的受赠者比核心医院的受赠者年轻。其他参数具有可比性。卫星医院的献血者比核心医院的献血者年轻。外围医院早期移植物功能障碍发生率低于核心医院(5例[10.20%]vs 11例[35.48%]，p = 0.009)。在卫星中心手术的患者术后住院时间也较短(15.96±6.75 vs 20.59±10.14,p = 0.018)。结论:该核心-卫星模型已被证明是一种有效的多中心肝移植模型，具有等效的结果。
{"title":"Liver Transplantation Program in India: The Core-Satellites Model","authors":"Magnus Mansard, R. Siddachari, Goutham Kumar, N. Subramanian, A. Olithselvan","doi":"10.7869/TG.579","DOIUrl":"https://doi.org/10.7869/TG.579","url":null,"abstract":"Background : Liver transplants in India are mostly done in a few large volume centers. There are many small volume centers which use the expertise and support from these large volume centers to carry out liver transplantations. The effectiveness of this model where a core large volume center supports the smaller volume satellite centers has not been evaluated before. Aim : To assess the outcomes of patients transplanted atsatellite centres and monitored remotely and compare them with those transplanted in the core center and managed by an in-house team. Results : The recipients in the satellite centers were younger than those in the core hospital. The other parameters were comparable. The donors were younger in the satellite hospitals than those in the core hospital.The incidence of early graft dysfunction was lesser in the peripheral hospitals than in the core hospital (5 [10.20%] vs 11 [35.48%],p = 0.009). The length of postoperative hospital stay was also lesser among patients operated in the satellite centers (15.96 ± 6.75 vs 20.59 ± 10.14, p = 0.018). Conclusion : This core-satellites model has been shown to be an effective model in the performance of liver transplantations at multiple centers with equivalent outcomes.","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":"15 1","pages":"54-59"},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84394132","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}
A. Javed, Shashi Kiran Bd, Aravinda Ps, M. Saravanan, A. Agarwal
Background: Surgical options for patients of chronic pancreatitis with refractory pain include drainage and/or resectional procedures. Lateral pancreatojejunostomy (LPJ), the commonly performed drainage operation has traditionally been done as open procedure. Laparoscopic LPJ is a technically demanding procedures and is presently gaining acceptance in many centers. Patients and methods: Retrospective analysis of prospectively maintained patient database of chronic pancreatitis at our center from January 2007 to April 2018. Results: During the study period, 41 patients underwent laparoscopic LPJ and constituted the study group. Of the 41 patients, 26 were male.Their mean age was 30.7 (7-51) years. Pain was the main indication of surgery. Nine patients had diabetes and 6 had steatorrhea. The mean MPD diameter was 13.6 (8-25) mm. The mean duration of surgery was 180 (140-340) min and blood loss was 110 ml. There was no mortality. Postoperative hospital stay was 5 (3-9) days and satisfactory pain relief was seen in 91% on at least 3 months follow-up. Follow-up period ranged from 1 to 109 months (average-43.6 months). Conclusions: Laparoscopic LPJ is feasible and safe with good short and long-term outcomes in selected groups of patients.However, it is a technically demanding procedure and should be done by a surgeon well versed with laparoscopic skills including suturing and knotting..
{"title":"Laparoscopic Lateral Pancreatico-jejunostomy: An Experience from a Tertiary Care Center","authors":"A. Javed, Shashi Kiran Bd, Aravinda Ps, M. Saravanan, A. Agarwal","doi":"10.7869/TG.581","DOIUrl":"https://doi.org/10.7869/TG.581","url":null,"abstract":"Background: Surgical options for patients of chronic pancreatitis with refractory pain include drainage and/or resectional procedures. Lateral pancreatojejunostomy (LPJ), the commonly performed drainage operation has traditionally been done as open procedure. Laparoscopic LPJ is a technically demanding procedures and is presently gaining acceptance in many centers. Patients and methods: Retrospective analysis of prospectively maintained patient database of chronic pancreatitis at our center from January 2007 to April 2018. Results: During the study period, 41 patients underwent laparoscopic LPJ and constituted the study group. Of the 41 patients, 26 were male.Their mean age was 30.7 (7-51) years. Pain was the main indication of surgery. Nine patients had diabetes and 6 had steatorrhea. The mean MPD diameter was 13.6 (8-25) mm. The mean duration of surgery was 180 (140-340) min and blood loss was 110 ml. There was no mortality. Postoperative hospital stay was 5 (3-9) days and satisfactory pain relief was seen in 91% on at least 3 months follow-up. Follow-up period ranged from 1 to 109 months (average-43.6 months). Conclusions: Laparoscopic LPJ is feasible and safe with good short and long-term outcomes in selected groups of patients.However, it is a technically demanding procedure and should be done by a surgeon well versed with laparoscopic skills including suturing and knotting..","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":"42 1","pages":"66-72"},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85521578","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}
U. Anand, Ramesh Kumar, R. Priyadarshi, B. Kumar, Sanjay Kumar, K. Parasar
Background: There is a lack of data describing the clinical profile, complications, and treatment outcome of patients with idiopathic chronic pancreatitis (ICP) from Eastern India. The current study aimed to present data on these aspects from a tertiary care centre of Bihar a part of Eastern India. Methods: Prospective data were collected with regard to clinic-epidemiological profile, complication, and treatment outcome from each patient of ICP (n=129). The median follow-up period was 3.8 (01 06) years. Results: ICP constituted the most common (64.1%, 129/201) cause of chronic pancreatitis. The mean age ± SD of ICP patients was 31.5 ± 11.2 years, and 71 (55%) were male. Diabetes and symptomatic steatorrhea were found in 25% (n=33) and 6.2% (n=08) patients. Pancreatic head mass was found in 43 (33%) patients, of which 17 (39.5%) was malignant. When patients were categorized into early-onset (= 30 years) and late-onset (>30 years) groups, no significant difference was found with regard to the proportion of patients with diabetes, head mass, and malignancy. The majority (69.7%) of patients required surgery (Frey’s procedure) due to failed medical therapy. Seventy-four (82%) patients had significant pain relief during a median follow-up of 3.8 years after surgery. Conclusions: ICP is the most common cause of chronic pancreatitis in Bihar. The majority of such patients are young, with slight male preponderance. They have a significant risk of developing diabetes and pancreatic malignancy. They are poorly responsive to medical therapy, and the outcome of surgical therapy is good.
{"title":"Idiopathic Chronic Pancreatitis in Bihar: A Perspective from Eastern India","authors":"U. Anand, Ramesh Kumar, R. Priyadarshi, B. Kumar, Sanjay Kumar, K. Parasar","doi":"10.7869/TG.580","DOIUrl":"https://doi.org/10.7869/TG.580","url":null,"abstract":"Background: There is a lack of data describing the clinical profile, complications, and treatment outcome of patients with idiopathic chronic pancreatitis (ICP) from Eastern India. The current study aimed to present data on these aspects from a tertiary care centre of Bihar a part of Eastern India. Methods: Prospective data were collected with regard to clinic-epidemiological profile, complication, and treatment outcome from each patient of ICP (n=129). The median follow-up period was 3.8 (01 06) years. Results: ICP constituted the most common (64.1%, 129/201) cause of chronic pancreatitis. The mean age ± SD of ICP patients was 31.5 ± 11.2 years, and 71 (55%) were male. Diabetes and symptomatic steatorrhea were found in 25% (n=33) and 6.2% (n=08) patients. Pancreatic head mass was found in 43 (33%) patients, of which 17 (39.5%) was malignant. When patients were categorized into early-onset (= 30 years) and late-onset (>30 years) groups, no significant difference was found with regard to the proportion of patients with diabetes, head mass, and malignancy. The majority (69.7%) of patients required surgery (Frey’s procedure) due to failed medical therapy. Seventy-four (82%) patients had significant pain relief during a median follow-up of 3.8 years after surgery. Conclusions: ICP is the most common cause of chronic pancreatitis in Bihar. The majority of such patients are young, with slight male preponderance. They have a significant risk of developing diabetes and pancreatic malignancy. They are poorly responsive to medical therapy, and the outcome of surgical therapy is good.","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":"44 1","pages":"60-65"},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85245498","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}
{"title":"Appointments: They give, I take","authors":"Vyom Aggarwal","doi":"10.7869/TG.583","DOIUrl":"https://doi.org/10.7869/TG.583","url":null,"abstract":"","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":"1 1","pages":"82-83"},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91354116","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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