Inflammatory bowel disease (IBD) is associated with increased rates of malignancies; some are disease-related (like colorectal cancer) and some are primarily associated with therapy exposures. Although there may be an overlap between disease- and therapy-related cancers, the general strategy for prevention of cancer in patients with IBD lies in understanding the risk factors for these malignancies, educating patients about the recommended screening and surveillance practices, and incorporating general screening recommendations into routine IBD care. An important limitation to our understanding of the effectiveness of our intervention and prevention strategies is the lack of studies assessing mortality benefit, but in part also a reflection of the low mortality in our IBD population. In practice, it is imperative to weigh the risks of cancer or other treatment-related complications in the context of disease progression as a result of lack of or ineffective treatment for IBD when tailoring a management plan for each patient.
{"title":"CANCER PREVENTION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE.","authors":"Noa Krugliak Cleveland, David T Rubin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is associated with increased rates of malignancies; some are disease-related (like colorectal cancer) and some are primarily associated with therapy exposures. Although there may be an overlap between disease- and therapy-related cancers, the general strategy for prevention of cancer in patients with IBD lies in understanding the risk factors for these malignancies, educating patients about the recommended screening and surveillance practices, and incorporating general screening recommendations into routine IBD care. An important limitation to our understanding of the effectiveness of our intervention and prevention strategies is the lack of studies assessing mortality benefit, but in part also a reflection of the low mortality in our IBD population. In practice, it is imperative to weigh the risks of cancer or other treatment-related complications in the context of disease progression as a result of lack of or ineffective treatment for IBD when tailoring a management plan for each patient.</p>","PeriodicalId":43949,"journal":{"name":"PRACTICAL GASTROENTEROLOGY","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8547793/pdf/nihms-1747066.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39565600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carmelo Blanquicett, Terence Dunn, Arjun Nanda, Frederick Weber
Typical causes of intermittent esophageal dysphagia in a young person include eosinophilic esophagitis, esophageal dysmotility and esophageal rings. We report a 35-year-old male with a one year history of intermittent dysphagia to solid foods. After the endoscopic removal of a food bolus, a barium swallow revealed extrinsic compression of the proximal esophagus. Computed tomography angiogram revealed an aberrant right subclavian artery (ARSA) coursing behind the esophagus, suggesting the diagnosis of dysphagia lusoria. Although rare, dysphagia lusoria represents an important consideration in the differential diagnosis of intermittent esophageal dysphagia in a young adult.
{"title":"An Uncommon Cause of Dysphagia in a 35 Year Old Male.","authors":"Carmelo Blanquicett, Terence Dunn, Arjun Nanda, Frederick Weber","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Typical causes of intermittent esophageal dysphagia in a young person include eosinophilic esophagitis, esophageal dysmotility and esophageal rings. We report a 35-year-old male with a one year history of intermittent dysphagia to solid foods. After the endoscopic removal of a food bolus, a barium swallow revealed extrinsic compression of the proximal esophagus. Computed tomography angiogram revealed an aberrant right subclavian artery (ARSA) coursing behind the esophagus, suggesting the diagnosis of dysphagia lusoria. Although rare, dysphagia lusoria represents an important consideration in the differential diagnosis of intermittent esophageal dysphagia in a young adult.</p>","PeriodicalId":43949,"journal":{"name":"PRACTICAL GASTROENTEROLOGY","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5933880/pdf/nihms960602.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36076610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-10-01DOI: 10.14309/00000434-201210001-00749
Amy Welch, T. Mcgarrity, H. Mani, M. Moyer
without dysplasia. Immunohistochemical staining for p53 and Ki67 were negative. Patient is scheduled for repeat pancreatoscopy surveillance in 6 months. Main duct IPMN carries a signifi cant risk of malignant transformation. Total pancreatectomy is a morbid procedure, and oft en surgeons choose to remove area of dysplasia leaving non-dysplastic IPMN in the remaining duct. We present a through-the-colonoscope application of SpyGlass system that allows for improved surveillance of patients with residual IPMN. Th is procedure may have wider application in patients aft er Whipple resection.
{"title":"Cystic neuroendocrine tumor of the pancreas: A rare type of pancreatic cystic lesion accurately diagnosed and staged by EUS-FNA","authors":"Amy Welch, T. Mcgarrity, H. Mani, M. Moyer","doi":"10.14309/00000434-201210001-00749","DOIUrl":"https://doi.org/10.14309/00000434-201210001-00749","url":null,"abstract":"without dysplasia. Immunohistochemical staining for p53 and Ki67 were negative. Patient is scheduled for repeat pancreatoscopy surveillance in 6 months. Main duct IPMN carries a signifi cant risk of malignant transformation. Total pancreatectomy is a morbid procedure, and oft en surgeons choose to remove area of dysplasia leaving non-dysplastic IPMN in the remaining duct. We present a through-the-colonoscope application of SpyGlass system that allows for improved surveillance of patients with residual IPMN. Th is procedure may have wider application in patients aft er Whipple resection.","PeriodicalId":43949,"journal":{"name":"PRACTICAL GASTROENTEROLOGY","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67048997","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}
Pub Date : 2008-09-01DOI: 10.14309/00000434-200809001-01056
Joel R. Judah, C. Hammond, S. Polyak, W. Drane, J. Valentine
50 INTRODUCTION T akayasu arteritis (TA) is a chronic granulomatous vasculitis that primarily affects the aorta and its primary branches, resulting in thickening of the walls of affected arteries (1,2). This disease results in an inflammatory process that manifests clinically with a wide range of systemic symptoms (3). Symptoms may include fatigue, weight-loss, and low-grade fever along with cool pulseless extremities, differential blood pressures in the left and right arm, claudication, hypertension, and bruits secondary to the stenotic lesions. Crohn’s disease (CD) is a granulomatous, transmural inflammation of the gastrointestinal tract most commonly affecting the ileum and cecum but may affect any portion of the small intestine and colon. The Coexistence of Crohn’s Disease and Takayasu Arteritis: Diagnosis and Treatment of Combined Disease in Three Patients A THREE-CASE REPORT
{"title":"The coexistence of Crohn's disease and Takayasu arteritis: Diagnosis and treatment of combined disease in three patients","authors":"Joel R. Judah, C. Hammond, S. Polyak, W. Drane, J. Valentine","doi":"10.14309/00000434-200809001-01056","DOIUrl":"https://doi.org/10.14309/00000434-200809001-01056","url":null,"abstract":"50 INTRODUCTION T akayasu arteritis (TA) is a chronic granulomatous vasculitis that primarily affects the aorta and its primary branches, resulting in thickening of the walls of affected arteries (1,2). This disease results in an inflammatory process that manifests clinically with a wide range of systemic symptoms (3). Symptoms may include fatigue, weight-loss, and low-grade fever along with cool pulseless extremities, differential blood pressures in the left and right arm, claudication, hypertension, and bruits secondary to the stenotic lesions. Crohn’s disease (CD) is a granulomatous, transmural inflammation of the gastrointestinal tract most commonly affecting the ileum and cecum but may affect any portion of the small intestine and colon. The Coexistence of Crohn’s Disease and Takayasu Arteritis: Diagnosis and Treatment of Combined Disease in Three Patients A THREE-CASE REPORT","PeriodicalId":43949,"journal":{"name":"PRACTICAL GASTROENTEROLOGY","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67039288","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}
Pub Date : 2005-09-01DOI: 10.14309/00000434-200509001-00498
R. S. S. Biyyani, S. Battula, Linda Chessler, L. Kirchner, J. King
Raja Shekhar R. Sappati Biyyani, M.D., Internal Medicine Resident (PGY-3), Canton Medical Education Foundation, Canton, Ohio. Linda Chessler, Research Associate, Mercy Medical Center, Canton, Ohio. James F. King, M.D., MACG, FACP. Professor of Medicine, GI Section, North Eastern Ohio Universities College of Medicine, Mercy Medical Center, Canton, Ohio. The natural history of Barrett’s esophagus (BE) is a matter of debate in the gastrointestinal literature. We report two unique presentations of BE, which demonstrate highly variable biologic behavior. This poses a management dilemma when faced with options of surveillance, surgery or ablation modalities. These cases suggest, advancement from HGD to BEAC is not always rapid and the cancer can have variable biologic behavior. We report two interesting cases wherein one developed poorly differentiated adenocarcinoma and the other developed changes approaching adenocarcinoma. Both remained asymptomatic and died of non-gastrointestinal causes. These cases demonstrate the fact that, patients often do not die from BE or BEAC but most often from concurrent cardiovascular disease. The surveillance endoscopies appear to have made little difference in the quality or duration of their lives. Raja Shekhar R. Sappati Biyyani Linda Chessler James F. King
{"title":"The Natural History of Barrettʼs Dysplasia and Adenocarcinoma: 498","authors":"R. S. S. Biyyani, S. Battula, Linda Chessler, L. Kirchner, J. King","doi":"10.14309/00000434-200509001-00498","DOIUrl":"https://doi.org/10.14309/00000434-200509001-00498","url":null,"abstract":"Raja Shekhar R. Sappati Biyyani, M.D., Internal Medicine Resident (PGY-3), Canton Medical Education Foundation, Canton, Ohio. Linda Chessler, Research Associate, Mercy Medical Center, Canton, Ohio. James F. King, M.D., MACG, FACP. Professor of Medicine, GI Section, North Eastern Ohio Universities College of Medicine, Mercy Medical Center, Canton, Ohio. The natural history of Barrett’s esophagus (BE) is a matter of debate in the gastrointestinal literature. We report two unique presentations of BE, which demonstrate highly variable biologic behavior. This poses a management dilemma when faced with options of surveillance, surgery or ablation modalities. These cases suggest, advancement from HGD to BEAC is not always rapid and the cancer can have variable biologic behavior. We report two interesting cases wherein one developed poorly differentiated adenocarcinoma and the other developed changes approaching adenocarcinoma. Both remained asymptomatic and died of non-gastrointestinal causes. These cases demonstrate the fact that, patients often do not die from BE or BEAC but most often from concurrent cardiovascular disease. The surveillance endoscopies appear to have made little difference in the quality or duration of their lives. Raja Shekhar R. Sappati Biyyani Linda Chessler James F. King","PeriodicalId":43949,"journal":{"name":"PRACTICAL GASTROENTEROLOGY","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67038218","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}
Pub Date : 2002-09-01DOI: 10.1016/S0002-9270(02)05125-0
K. S. Kumar, J. Murray
{"title":"Squamous papillomatosis of the esophagus","authors":"K. S. Kumar, J. Murray","doi":"10.1016/S0002-9270(02)05125-0","DOIUrl":"https://doi.org/10.1016/S0002-9270(02)05125-0","url":null,"abstract":"","PeriodicalId":43949,"journal":{"name":"PRACTICAL GASTROENTEROLOGY","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0002-9270(02)05125-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55481208","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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