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Delayed colonic perforation secondary to cold snare polypectomy 冷套管息肉切除术继发的延迟性结肠穿孔
IF 2.6 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-06-26 DOI: 10.1136/flgastro-2024-102742
Jan Kubovy, Matthew Drake, Rajan N Patel
Cold snare polypectomy (CSP) is the treatment of choice for polyps less than 10 mm in size and sessile serrated lesions.1 We present a 66-year-old woman with Crohn’s colitis. Inflammatory bowel disease (IBD) was in complete clinico-endoscopic remission and colonoscopy was performed for dysplasia surveillance. …
冷套管息肉切除术(CSP)是治疗小于 10 毫米的息肉和无柄锯齿状病变的首选方法。炎症性肠病(IBD)在临床内镜下已完全缓解,结肠镜检查是为了监测发育不良。...
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引用次数: 0
Uncommon cause of pancreatitis 20 years after cholecystectomy 胆囊切除术后 20 年胰腺炎的罕见病因
IF 2.6 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-06-20 DOI: 10.1136/flgastro-2024-102764
Heng Chi, Michael Staessens, Wim J Lammers, Pieter Jan F de Jonge
A 65-year-old woman with a medical history of cholecystectomy 20 years ago was referred to our hospital for recurrent colic pain in the upper abdomen with intermittent cholestatic liver enzyme abnormalities. She also experienced an episode of acute pancreatitis 2 weeks before the presentation. CT showed a dilated common bile duct with a hyperdense object of 10×4 mm in the distal common bile duct, suspecting …
一名 65 岁的妇女 20 年前曾做过胆囊切除术,因上腹反复绞痛并伴有间歇性胆汁淤积性肝酶异常而转诊至我院。就诊前两周,她还经历过一次急性胰腺炎发作。CT显示胆总管扩张,胆总管远端有一个10×4毫米的高密度物,怀疑...
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引用次数: 0
Rwandan man with a case of the blues 患忧郁症的卢旺达人
IF 2.6 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-06-20 DOI: 10.1136/flgastro-2024-102722
Benjamin Wipper, Hanna Blaney, Robert Giraneza, Prosper Ingabire, Vincent Dusabejambo, Udit Asija, Erik C von Rosenvinge
A Rwandan man in his 40s underwent an upper gastrointestinal endoscopy for evaluation of solid-food dysphagia. Of note, the patient also reported a long-standing history of anaemia, which was originally diagnosed in 2000. He had required four transfusions since and noted that he had previously been prescribed tot’hema syrup (a form of iron supplementation) but was no longer taking it. Laboratory tests around the time of endoscopy showed microcytic anaemia (haemoglobin 99.1 g/L, median corpuscular volume 61.84 fL) with an elevated reticulocyte count (91×109/L). Further labs showed low serum iron (28 mcg/dL) and ferritin (20.5 ng/mL). The patient denied ever experiencing melena or haematochezia. Endoscopic examination revealed a partially obstructing Schatzki’s ring as the explanation for his dysphagia and this was treated with balloon dilation. The endoscopy also revealed numerous blue-violet vascular-appearing …
一名 40 多岁的卢旺达男子因固体食物吞咽困难接受了上消化道内窥镜检查。值得注意的是,患者还报告了长期的贫血病史,最初于 2000 年确诊。从那时起,他需要进行四次输血,并指出他以前曾服用过tot'hema糖浆(一种铁质补充剂),但现在已不再服用。内窥镜检查前后的实验室检查显示他患有小细胞性贫血(血红蛋白 99.1 g/L,中位血球容积 61.84 fL),网织红细胞计数升高(91×109/L)。进一步化验结果显示血清铁(28 mcg/dL)和铁蛋白(20.5 ng/mL)偏低。患者否认曾出现过血块或血便。内窥镜检查显示,沙茨基环部分阻塞是导致其吞咽困难的原因,因此对其进行了球囊扩张治疗。内镜检查还发现了许多蓝紫色血管外观的...
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引用次数: 0
Whitish colonic mucosa 结肠粘膜变白
IF 2.6 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-06-18 DOI: 10.1136/flgastro-2024-102765
Joaquin Fisac-Vazquez, Laura G-Pastrian, Marta de Uribe-Viloria, Maria Dolores Martin-Arranz
An asymptomatic 65-year-old woman was referred to our endoscopy unit after a screening positive faecal occult blood test. Colonoscopy revealed a pale, whitish colonic mucosa with yellowish specks (figure 1), congestive areas and foci of lymphoid follicular hyperplasia (figure 2). Sessile lesions (0-Is) with whitish speckling on their surface were also identified. Figure 1 Whitish colonic mucosa with yellowish specks. Figure 2 Congestive areas and foci of lymphoid follicular hyperplasia. On histology, a dense infiltrate of foamy macrophages was …
一名无症状的 65 岁妇女在粪便潜血试验呈阳性后被转诊到我们的内镜室。结肠镜检查发现,结肠粘膜苍白,有淡黄色斑点(图 1)、充血区和淋巴滤泡增生灶(图 2)。此外,还发现了表面有白色斑点的无柄病变(0-Is)。图 1 带有淡黄色斑点的白色结肠粘膜。图 2 淋巴滤泡增生的充血区和病灶。组织学检查发现,泡沫状巨噬细胞密集浸润。
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引用次数: 0
Environmental impact assessment in healthcare: utility and limitations 医疗保健中的环境影响评估:实用性和局限性
IF 2.6 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-31 DOI: 10.1136/flgastro-2023-102473
Robin Baddeley, Nikolaos Voulvoulis, Siwan Thomas-Gibson, Bu'Hussain Hayee
Concern regarding the environmental impact of healthcare provision is now accompanied by a legal commitment for the NHS to align itself with national emissions targets. Meanwhile, the academic literature increasingly features environmental impact assessments focused on healthcare products, processes and systems. However, the current evidence base contains significant methodological heterogeneity, and the healthcare context demands that particular considerations are made when interpreting the findings from these studies. In this article, we consider the role environmental accounting methodologies can play in the effort to achieve environmental sustainability in healthcare; their utility and limitations.
在关注医疗服务对环境影响的同时,英国国家医疗服务体系(NHS)也做出了与国家排放目标保持一致的法律承诺。与此同时,学术文献也越来越多地关注医疗产品、流程和系统的环境影响评估。然而,目前的证据基础在方法上存在很大的不一致性,而且医疗保健的背景要求在解释这些研究结果时做出特别的考虑。在本文中,我们将探讨环境核算方法在努力实现医疗保健行业环境可持续性方面所能发挥的作用,以及这些方法的实用性和局限性。
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引用次数: 0
Unique cause of acute pancreatitis 急性胰腺炎的独特病因
IF 2.6 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-29 DOI: 10.1136/flgastro-2024-102673
Rory James McCluskey, Jessie Elliott, Jan Leyden, John Conneely, Gerry McEntee, Suzanne O'Mahony, Niall McInerney
A previously well 43-year-old men was admitted with right upper quadrant and epigastric pain, fever and vomiting. His medical history included asymptomatic cholestatic liver function tests for which serial ultrasound (US), magnetic resonance cholangiopancreatography, fibroscan and a US-guided liver biopsy had proved unremarkable several years prior to this presentation. Physical examination revealed diffuse abdominal tenderness worst in the right upper quadrant and epigastric region. Laboratory investigations demonstrated raised inflammatory markers and deranged liver function but were otherwise unremarkable. CT of the abdomen and pelvis showed extensive pancreatic stranding and fluid most prominent around the tail and body of the pancreas. The patient had no history of gallstones, alcohol misuse, new medications, family history or hypercholesterolemia. The patient was managed conservatively but subsequently deteriorated with features of abdominal sepsis. Serial …
一名 43 岁的男性因右上腹和上腹痛、发烧和呕吐入院。他的病史包括无症状性胆汁淤积性肝功能检查,在这次就诊前的几年里,连续的超声波(US)、磁共振胆胰造影、纤维扫描和 US 引导下的肝活检均未发现异常。体格检查显示,右上腹和上腹部弥漫性压痛最严重。实验室检查显示炎症标志物升高,肝功能异常,但其他方面无异常。腹部和盆腔CT显示,胰腺尾部和胰体周围有广泛的胰腺绞窄和积液。患者没有胆结石史、酗酒史、新服药史、家族史或高胆固醇血症史。患者接受了保守治疗,但随后病情恶化,出现腹腔败血症特征。连续...
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引用次数: 0
Climate change and gastroenterology: from the frontline 气候变化与肠胃病学:从第一线出发
IF 2.6 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-13 DOI: 10.1136/flgastro-2023-102500
Mai Ling Perman
Despite contributing minimally to global greenhouse gas emissions,1 Pacific Island nations are at the frontline of climate change impacts.2 Their heightened vulnerability stems from their geographical dispersal across the expansive Pacific Ocean, which leaves them encircled by vast bodies of water. This unique geological position subjects these island communities to climate-related threats, including rising sea levels, coastline erosion, ocean acidification, loss of biodiversity, food and water insecurities and extreme weather events, jeopardising their existence and way of life. Oceania comprises Australia, New Zealand and the PICs and territories (see figure 1). The three ethnogeographic regions (Melanesia, Micronesia and Polynesia) form the PICs. Of these, 13 are sovereign nations, while others maintain unique political associations with France, New Zealand and the USA. Figure 1 Map of Oceania (Source: map-oceania-05.gif (720×410) (globalsecurity.org). The self-governing nations have almost 13 million people but only about 2.7 million live on the smaller islands.3 They are classified as low-income and middle-income countries.3 These include the Federated States of Micronesia, Fiji, Kiribati, the Republic of the Marshall Islands (RMI), Nauru, Papua New Guinea, Samoa, the Solomon Islands, Tonga, Tuvalu and Vanuatu. Each country boasts a unique blend of culture, tradition, history and political systems. As Earth becomes warmer due to climate change, sea levels rise via two main mechanisms: expanding heated seawater and melting ice sheets and glaciers.2 Because some PICs are low-lying atolls, they face the potential existential threat of vanishing underwater with rising sea levels. The countries with the most significant threat of ‘sinking’ first are Tuvalu, Kiribati and the Republic of the Marshall Islands. Their highest elevations vary from atoll to atoll, but, generally, they are mostly under 5 m above sea level. The only bridge, which is the highest peak (<10 m above sea level) in Majuro, Republic of the …
尽管太平洋岛国对全球温室气体排放的贡献微乎其微,1 但它们却处于气候变 化影响的最前沿。2 它们的高度脆弱性源于它们分散在广阔的太平洋上的地理位 置,这使它们被大片水域所包围。这种独特的地理位置使这些岛屿社区面临与气候有关的威胁,包括海平面上升、海岸线侵蚀、海洋酸化、生物多样性丧失、粮食和水不安全以及极端天气事件,危及它们的生存和生活方式。大洋洲包括澳大利亚、新西兰、太平洋岛屿国家和领土(见图 1)。三个民族地理区域(美拉尼西亚、密克罗尼西亚和波利尼西亚)构成太平洋岛屿国家。其中 13 个是主权国家,其他则与法国、新西兰和美国保持独特的政治联系。图 1 大洋洲地图(来源:map-oceania-05.gif (720×410) (globalsecurity.org).3 这些国家包括密克罗尼西亚联邦、斐济、基里巴斯、马绍尔群岛共和国(RMI)、瑙鲁、巴布亚新几内亚、萨摩亚、所罗门群岛、汤加、图瓦卢和瓦努阿图。每个国家都拥有独特的文化、传统、历史和政治制度。随着气候变化导致地球变暖,海平面会通过两个主要机制上升:受热海水膨胀以及冰原和冰川融化。2 由于一些太平洋岛屿国家是低洼环礁,它们面临着随着海平面上升而消失在水下的潜在生存威胁。首先面临 "沉没 "威胁最大的国家是图瓦卢、基里巴斯和马绍尔群岛共和国。它们的最高海拔因环礁而异,但一般都在海平面 5 米以下。马绍尔群岛共和国马朱罗的最高峰(海拔<10 米)只有一座桥。
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引用次数: 0
Perforation of the fourth duodenal segment and peritonitis caused by a bezoar 牛粪石引起的第四段十二指肠穿孔和腹膜炎
IF 2.6 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-10 DOI: 10.1136/flgastro-2024-102739
Baptiste Massart, Chieh-Wen Lai, Kian-Hwee Chong, Jia-Hui Chen
A 43-year-old woman presented with 1 day of epigastric pain and a developing fever. She was tachycardic and febrile. Physical examination showed rebound tenderness on the left upper quadrant with decreased bowel sounds. CT of the abdomen revealed duodenal perforation surrounding a mass of unknown nature (figure 1). An oesophagogastroduodenoscopy showed a phytobezoar unusually located in the fourth duodenal segment (figure 2). A bezoar is a rare cause of small bowel perforation that most frequently occurs in …
一名 43 岁的妇女因上腹疼痛 1 天和发烧就诊。她心动过速,发热。体格检查显示左上腹有反跳痛,肠鸣音减弱。腹部 CT 显示十二指肠穿孔,周围有一个性质不明的肿块(图 1)。食管胃十二指肠镜检查显示,位于第四段十二指肠内的植物牛粪状肿块异常增大(图 2)。牛粪动物是一种罕见的小肠穿孔病因,最常发生在...
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引用次数: 0
Unusual cause of recurrent vomiting in a patient with duodenal stenosis 十二指肠狭窄患者反复呕吐的不寻常原因
IF 2.6 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-08 DOI: 10.1136/flgastro-2024-102643
Jian-Wei Liu, Ru-Yuan Li
A 44-year-old man was referred to our hospital with a 2-week history of abdominal distention, nausea and recurrent vomiting. The past medical history disclosed peptic ulcer-related duodenal stenosis at the bulb for 3 years and cholecystolithiasis for 20 years. On examination, the abdomen was distended and soft with no tenderness. Blood laboratory tests showed leucocytosis (12.10×109/L, reference 3.5–9.5), mild hypokalaemia (3.25 mmol/L, reference 3.5–5.3), normal C reactive protein, liver function, renal function and coagulation function. An abdominal CT showed a typical Rigler’s triad: pneumobilia, …
一名 44 岁男子因腹胀、恶心和反复呕吐 2 周病史被转诊至我院。既往病史显示,消化性溃疡相关十二指肠球部狭窄 3 年,胆囊结石 20 年。经检查,腹部胀满、柔软,无压痛。血液实验室检查显示白细胞增多(12.10×109/L,参考值3.5-9.5),轻度低钾血症(3.25 mmol/L,参考值3.5-5.3),C反应蛋白、肝功能、肾功能和凝血功能正常。腹部 CT 显示典型的里格勒三联征:气胸、...
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引用次数: 0
Reflux riddle: an unforeseen element at the gastro-oesophageal junction 反流之谜:胃食管交界处的意外因素
IF 2.6 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-08 DOI: 10.1136/flgastro-2024-102654
Swathi Prabhu, Anuradha Calicut Kini Rao, Vishwanath Basavaraj
A 70-year-old woman presented to the gastroenterology clinic with a 2-month history of acid reflux, heartburn and dysphagia. A clinical diagnosis of gastro-oesophageal reflux disease was made. Upper gastrointestinal (GI) endoscopy (figure 1) revealed a hiatus hernia with a red smooth surfaced lump at the gastro-oesophageal junction (GOJ), measuring 1 cm in diameter. The biopsy in our case threw up an unusual surprise of …
一名 70 岁的妇女因两个月的反酸、烧心和吞咽困难病史来到胃肠病诊所就诊。临床诊断为胃食管反流病。上消化道(GI)内窥镜检查(图 1)显示患者患有食管裂孔疝,胃食管交界处(GOJ)有一个红色光滑肿块,直径 1 厘米。在我们的病例中,活组织检查发现了一个不寻常的...
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引用次数: 0
期刊
Frontline Gastroenterology
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