Pub Date : 2025-01-01DOI: 10.1016/j.gastha.2024.10.016
Brandon Rodgers, Abraham Mathew, Hadie Razjouyan
Malignant bowel obstruction is a challenging complication in advanced gastrointestinal malignancies with varying treatment strategies including medical, surgical and endoscopic therapies, each with their own limitations. Endoscopic ultrasound–guided enterocolostomy has been previously reported as an option for patients who are not surgical candidates or ideal candidates for enteral stenting. In this case, endoscopic ultrasound–guided enterocolostomy is used for the palliation in a patient with a completely obstructing large cecal adenocarcinoma who declined surgical intervention.
{"title":"EUS Guided Enterocolostomy for the Palliation of Malignant Small Bowel Obstruction From a Cecal Adenocarcinoma","authors":"Brandon Rodgers, Abraham Mathew, Hadie Razjouyan","doi":"10.1016/j.gastha.2024.10.016","DOIUrl":"10.1016/j.gastha.2024.10.016","url":null,"abstract":"<div><div>Malignant bowel obstruction is a challenging complication in advanced gastrointestinal malignancies with varying treatment strategies including medical, surgical and endoscopic therapies, each with their own limitations. Endoscopic ultrasound–guided enterocolostomy has been previously reported as an option for patients who are not surgical candidates or ideal candidates for enteral stenting. In this case, endoscopic ultrasound–guided enterocolostomy is used for the palliation in a patient with a completely obstructing large cecal adenocarcinoma who declined surgical intervention.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100576"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081873","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 : 2025-01-01DOI: 10.1016/j.gastha.2025.100616
{"title":"Cover: Properties of Human Colonic Myenteric Neurons Differ Depending on Age, Disorder, and Colonic Region","authors":"","doi":"10.1016/j.gastha.2025.100616","DOIUrl":"10.1016/j.gastha.2025.100616","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100616"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143164272","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 : 2025-01-01DOI: 10.1016/j.gastha.2024.10.020
Hans Gregersen , Bhavesh Patel , Xiaomei Guo , Giuliana Barron Del Solar , Samuel Eisenstein , Ghassan Kassab
{"title":"Anorectal Friction Force Is Reduced in Fecal Incontinence","authors":"Hans Gregersen , Bhavesh Patel , Xiaomei Guo , Giuliana Barron Del Solar , Samuel Eisenstein , Ghassan Kassab","doi":"10.1016/j.gastha.2024.10.020","DOIUrl":"10.1016/j.gastha.2024.10.020","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100580"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167819","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}
{"title":"Anti-Integrin αvβ6 Antibody Titer as a Predictive Biomarker of Future Treatment Escalation in Patients With Ulcerative Colitis","authors":"Shuji Yamamoto, Takeshi Kuwada, Masahiro Shiokawa, Hiroki Kitamoto, Makoto Okabe, Hiroshi Seno","doi":"10.1016/j.gastha.2024.10.022","DOIUrl":"10.1016/j.gastha.2024.10.022","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100582"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167820","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 : 2025-01-01DOI: 10.1016/j.gastha.2024.09.001
Andy Yu , Gabriel M. Knight , Justin Boike , Bartley Thornburg , Riad Salem
Portal vein recanalization transjugular intrahepatic portosystemic shunt (PVR-TIPS) is a safe and effective procedure for decompression of portal hypertension (PH). In this short case series, 2 women with chronic noncirrhotic portal vein thrombosis were treated with PVR-TIPS. Both patients hoped to conceive. Without treatment for their PH, their pregnancies posed a significant risk of life-threatening variceal bleeding. Both patients tolerated the procedure well and delivered without complications of PH. In future cases of noncirrhotic portal vein thrombosis in patients hoping to conceive, PVR-TIPS should be considered for definitive treatment of PH.
{"title":"Portal Vein Recanalization Transjugular Intrahepatic Portosystemic Shunt for Noncirrhotic Chronic Portal Vein Thrombosis Leading to Successful Pregnancy: Case Report","authors":"Andy Yu , Gabriel M. Knight , Justin Boike , Bartley Thornburg , Riad Salem","doi":"10.1016/j.gastha.2024.09.001","DOIUrl":"10.1016/j.gastha.2024.09.001","url":null,"abstract":"<div><div>Portal vein recanalization transjugular intrahepatic portosystemic shunt (PVR-TIPS) is a safe and effective procedure for decompression of portal hypertension (PH). In this short case series, 2 women with chronic noncirrhotic portal vein thrombosis were treated with PVR-TIPS. Both patients hoped to conceive. Without treatment for their PH, their pregnancies posed a significant risk of life-threatening variceal bleeding. Both patients tolerated the procedure well and delivered without complications of PH. In future cases of noncirrhotic portal vein thrombosis in patients hoping to conceive, PVR-TIPS should be considered for definitive treatment of PH.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100546"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959706","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 : 2025-01-01DOI: 10.1016/j.gastha.2024.06.014
Kimitoshi Kubo , Issei Ashida , Noriko Kimura
{"title":"Supine-Position Endoscopic Retrograde Cholangiopancreatography for a Patient With Severe Motor and Intellectual Disabilities","authors":"Kimitoshi Kubo , Issei Ashida , Noriko Kimura","doi":"10.1016/j.gastha.2024.06.014","DOIUrl":"10.1016/j.gastha.2024.06.014","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100507"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710315","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 : 2025-01-01DOI: 10.1016/j.gastha.2024.09.011
Chethan Ramprasad , Divya Saini , Henry Del Carmen , Lev Krasnovsky , Rajat Chandra , Ryan Mcgregor , Russell T. Shinohara , Eric Eaton , Meghna Gummadi , Shivan Mehta , James D. Lewis
Background and Aims
Inadequate bowel preparation which occurs in 25% of colonoscopies is a major barrier to the effectiveness of screening for colorectal cancer. We aim to develop an artificial intelligence (machine learning) algorithm to assess photos of stool output after bowel preparation to predict inadequate bowel preparation before colonoscopy.
Methods
Patients were asked to text a photo of their stool in the commode when they believed that they neared completion of their colonoscopy bowel preparation. Boston Bowel Preparation Scores of 7 and below were labeled as inadequate or fair. Boston Bowel Preparation Scores of 8 and 9 were considered good. A binary classification image-based machine learning algorithm was designed.
Results
In a test set of 61 images, the binary classification machine learning algorithm was able to distinguish inadequate/fair preparation from good preparation with a positive predictive value of 78.6% and a negative predictive value of 60.8%. In a test set of 56 images, the algorithm was able to distinguish normal colonoscopy duration (<25 minutes) from long colonoscopy duration (>25 minutes) with a positive predictive value of 78.6% and a negative predictive value of 65.5%.
Conclusion
Patients are willing to submit photos of their stool output during bowel preparation through text messages before colonoscopy. This machine learning algorithm demonstrates the ability to predict inadequate/fair preparation from good preparation based on image classification of stool output. It was less accurate to predict long duration of colonoscopy.
{"title":"Text Message System for the Prediction of Colonoscopy Bowel Preparation Adequacy Before Colonoscopy: An Artificial Intelligence Image Classification Algorithm Based on Images of Stool Output","authors":"Chethan Ramprasad , Divya Saini , Henry Del Carmen , Lev Krasnovsky , Rajat Chandra , Ryan Mcgregor , Russell T. Shinohara , Eric Eaton , Meghna Gummadi , Shivan Mehta , James D. Lewis","doi":"10.1016/j.gastha.2024.09.011","DOIUrl":"10.1016/j.gastha.2024.09.011","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Inadequate bowel preparation which occurs in 25% of colonoscopies is a major barrier to the effectiveness of screening for colorectal cancer. We aim to develop an artificial intelligence (machine learning) algorithm to assess photos of stool output after bowel preparation to predict inadequate bowel preparation before colonoscopy.</div></div><div><h3>Methods</h3><div>Patients were asked to text a photo of their stool in the commode when they believed that they neared completion of their colonoscopy bowel preparation. Boston Bowel Preparation Scores of 7 and below were labeled as inadequate or fair. Boston Bowel Preparation Scores of 8 and 9 were considered good. A binary classification image-based machine learning algorithm was designed.</div></div><div><h3>Results</h3><div>In a test set of 61 images, the binary classification machine learning algorithm was able to distinguish inadequate/fair preparation from good preparation with a positive predictive value of 78.6% and a negative predictive value of 60.8%. In a test set of 56 images, the algorithm was able to distinguish normal colonoscopy duration (<25 minutes) from long colonoscopy duration (>25 minutes) with a positive predictive value of 78.6% and a negative predictive value of 65.5%.</div></div><div><h3>Conclusion</h3><div>Patients are willing to submit photos of their stool output during bowel preparation through text messages before colonoscopy. This machine learning algorithm demonstrates the ability to predict inadequate/fair preparation from good preparation based on image classification of stool output. It was less accurate to predict long duration of colonoscopy.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100556"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049030","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 : 2025-01-01DOI: 10.1016/j.gastha.2024.10.001
Divya B. Dasani , Maria Isabel Fiel , Camila C. Simoes , Adam S. Morgenthau , Thomas D. Schiano
Background and Aims
Sarcoidosis is a multisystem disorder characterized by nonnecrotizing granulomas. Studies suggest 20%–70% of patients with sarcoidosis have abnormal liver chemistries or abdominal imaging. Hepatic sarcoidosis may be complicated by portal hypertension (portal HTN) with or without cirrhosis. Few studies have reviewed the liver histopathology of sarcoidosis.
Methods
Searching the pathology database using the terms “sarcoidosis” and “liver,” patients were identified and cross-referenced to patients in the Sarcoidosis Clinic. Patients met the diagnostic criteria for sarcoidosis. Those with isolated granulomatous hepatitis were excluded. Demographics, abdominal imaging, biochemistries, and detailed histological features were cataloged.
Results
Patients were separated into 2 groups: those with portal HTN with or without cirrhosis (pHTN+) and those without portal HTN (pHTN-). Fifty-three patients had biopsies available for review (pHTN+, n = 33; pHTN-, n = 20). The groups did not differ in the location, type, or number of granulomas. The pHTN + group had more bile duct damage (P = .025) and loss (P = .019). Patients in the pHTN + group also had biliary cirrhosis, nodular regenerative hyperplasia, or outflow obstruction.
Conclusion
There are several causes for portal HTN in sarcoidosis. Thus, liver biopsy is essential in its evaluation. Bile duct damage and loss are associated with the presence of portal HTN and cirrhosis. Biliary abnormalities may occur independently of granulomatous inflammation, and can thus identify a subset of patients at risk for progressive liver disease.
{"title":"The Varying Histology of Hepatic Sarcoidosis and the Relation of Bile Duct Damage and Loss to the Presence of Portal Hypertension and Cirrhosis","authors":"Divya B. Dasani , Maria Isabel Fiel , Camila C. Simoes , Adam S. Morgenthau , Thomas D. Schiano","doi":"10.1016/j.gastha.2024.10.001","DOIUrl":"10.1016/j.gastha.2024.10.001","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Sarcoidosis is a multisystem disorder characterized by nonnecrotizing granulomas. Studies suggest 20%–70% of patients with sarcoidosis have abnormal liver chemistries or abdominal imaging. Hepatic sarcoidosis may be complicated by portal hypertension (portal HTN) with or without cirrhosis. Few studies have reviewed the liver histopathology of sarcoidosis.</div></div><div><h3>Methods</h3><div>Searching the pathology database using the terms “sarcoidosis” and “liver,” patients were identified and cross-referenced to patients in the Sarcoidosis Clinic. Patients met the diagnostic criteria for sarcoidosis. Those with isolated granulomatous hepatitis were excluded. Demographics, abdominal imaging, biochemistries, and detailed histological features were cataloged.</div></div><div><h3>Results</h3><div>Patients were separated into 2 groups: those with portal HTN with or without cirrhosis (pHTN+) and those without portal HTN (pHTN-). Fifty-three patients had biopsies available for review (pHTN+, n = 33; pHTN-, n = 20). The groups did not differ in the location, type, or number of granulomas. The pHTN + group had more bile duct damage (<em>P</em> = .025) and loss (<em>P</em> = .019). Patients in the pHTN + group also had biliary cirrhosis, nodular regenerative hyperplasia, or outflow obstruction.</div></div><div><h3>Conclusion</h3><div>There are several causes for portal HTN in sarcoidosis. Thus, liver biopsy is essential in its evaluation. Bile duct damage and loss are associated with the presence of portal HTN and cirrhosis. Biliary abnormalities may occur independently of granulomatous inflammation, and can thus identify a subset of patients at risk for progressive liver disease.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100561"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049036","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 : 2025-01-01DOI: 10.1016/j.gastha.2024.10.009
Hideaki Kazumori
{"title":"Recurrent Respiratory Distress Caused by Temporary Herniation of Transverse Colon Into Hiatal Hernia in Patient With Kyphosis","authors":"Hideaki Kazumori","doi":"10.1016/j.gastha.2024.10.009","DOIUrl":"10.1016/j.gastha.2024.10.009","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100569"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061510","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}
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