Pub Date : 2020-09-01Epub Date: 2020-03-24DOI: 10.23736/S1121-421X.20.02667-7
Adriana Handra-Luca, Mouna Bendib, Christina Magkou
Background: The P38-protein is known to be expressed in colorectal adenomas (CRA). Expression in low- and high-grade tubular adenomas is decreased when compared to adenocarcinomas and increased with regard to normal mucosa. We aimed to study P38 expression in human CRAs and the relationships to cell proliferation Ki67-protein, stem-phenotype CD133-protein and, to mTOR-protein (AKT pathway).
Methods: The immunohistochemical expression of P38 was evaluated in CRAs on tissue microarrays. Data were analyzed with the Kendall-rank-correlation test.
Results: Nuclear P38 correlated to low-grade dysplasia (Kendall P<0.01/tau=-0.254) and to decreased adenoma size (P<0.01/tau=-0.267). Nuclear P38 also correlated to cytoplasmic or membrane mTOR (P<0.01/tau=-0.223 and P<0.01/tau=-0.340) and to cytoplasmic CD133 (P<0.01/0.293). An inverse relationship was observed to Ki67 (P<0.00/ tau=-0.110).
Conclusions: Our results suggest an interference of P38 with initial steps of colorectal adenomagenesis. The correlation to mTOR suggests a biological crosstalk between the MAPK- and AKT-signaling-pathways in colorectal adenomagenesis at P38 level.
{"title":"P38 expression in colorectal adenomas: relationships to cell proliferation, stem phenotype and AKT pathway proteins.","authors":"Adriana Handra-Luca, Mouna Bendib, Christina Magkou","doi":"10.23736/S1121-421X.20.02667-7","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02667-7","url":null,"abstract":"<p><strong>Background: </strong>The P38-protein is known to be expressed in colorectal adenomas (CRA). Expression in low- and high-grade tubular adenomas is decreased when compared to adenocarcinomas and increased with regard to normal mucosa. We aimed to study P38 expression in human CRAs and the relationships to cell proliferation Ki67-protein, stem-phenotype CD133-protein and, to mTOR-protein (AKT pathway).</p><p><strong>Methods: </strong>The immunohistochemical expression of P38 was evaluated in CRAs on tissue microarrays. Data were analyzed with the Kendall-rank-correlation test.</p><p><strong>Results: </strong>Nuclear P38 correlated to low-grade dysplasia (Kendall P<0.01/tau=-0.254) and to decreased adenoma size (P<0.01/tau=-0.267). Nuclear P38 also correlated to cytoplasmic or membrane mTOR (P<0.01/tau=-0.223 and P<0.01/tau=-0.340) and to cytoplasmic CD133 (P<0.01/0.293). An inverse relationship was observed to Ki67 (P<0.00/ tau=-0.110).</p><p><strong>Conclusions: </strong>Our results suggest an interference of P38 with initial steps of colorectal adenomagenesis. The correlation to mTOR suggests a biological crosstalk between the MAPK- and AKT-signaling-pathways in colorectal adenomagenesis at P38 level.</p>","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":" ","pages":"208-210"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37777666","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 : 2020-09-01Epub Date: 2020-03-24DOI: 10.23736/S1121-421X.20.02680-X
Marta Priora, Cristina Realmuto, Simone Parisi, Maria C Ditto, Richard Borrelli, Clara L Peroni, Angela Laganà, Enrico Fusaro
Beyond the classic hepatic complications, hepatitis C (HCV) infection is considered as a systemic disease, since extrahepatic manifestations become clinically evident in 40% to 70% of the patients and it can frequently include rheumatic ones. Furthermore, HCV can promote the production of several autoantibodies, thus complicating the differential diagnosis between primitive and HCV-related rheumatic disorders. The recent development of direct-acting antivirals (DAA) against HCV has revolutionized the field, reducing the damage stemming from systemic inflammatory phenomena and persistent immune activation associated with continuous HCV replication. Our review focuses on the main rheumatologic manifestations associated with chronic HCV infection as well as the impact of DAA interferon-free treatments on such extrahepatic clinical involvement.
{"title":"Rheumatologic manifestations of hepatitis C in the era of direct-acting antiviral agents.","authors":"Marta Priora, Cristina Realmuto, Simone Parisi, Maria C Ditto, Richard Borrelli, Clara L Peroni, Angela Laganà, Enrico Fusaro","doi":"10.23736/S1121-421X.20.02680-X","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02680-X","url":null,"abstract":"<p><p>Beyond the classic hepatic complications, hepatitis C (HCV) infection is considered as a systemic disease, since extrahepatic manifestations become clinically evident in 40% to 70% of the patients and it can frequently include rheumatic ones. Furthermore, HCV can promote the production of several autoantibodies, thus complicating the differential diagnosis between primitive and HCV-related rheumatic disorders. The recent development of direct-acting antivirals (DAA) against HCV has revolutionized the field, reducing the damage stemming from systemic inflammatory phenomena and persistent immune activation associated with continuous HCV replication. Our review focuses on the main rheumatologic manifestations associated with chronic HCV infection as well as the impact of DAA interferon-free treatments on such extrahepatic clinical involvement.</p>","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":" ","pages":"280-289"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37777672","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 : 2020-09-01Epub Date: 2020-04-23DOI: 10.23736/S1121-421X.20.02706-3
Amir Mari, Rinaldo Pellicano, Tawfik Khoury
{"title":"Salivary pepsin for the diagnosis of gastroesophageal reflux disease: what is its role in 2020?","authors":"Amir Mari, Rinaldo Pellicano, Tawfik Khoury","doi":"10.23736/S1121-421X.20.02706-3","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02706-3","url":null,"abstract":"","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":" ","pages":"181-183"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37866858","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 : 2020-09-01DOI: 10.23736/S1121-421X.20.02760-9
C. Pagnini, M. D. Di Paolo, L. D'alba, R. Urgesi, L. Pallotta, G. Villotti, G. D’ambra, G. delle Fave, M. Graziani
{"title":"Probiotics in COVID-19 pandemic: when evidence lacks, rationale can still ease the way.","authors":"C. Pagnini, M. D. Di Paolo, L. D'alba, R. Urgesi, L. Pallotta, G. Villotti, G. D’ambra, G. delle Fave, M. Graziani","doi":"10.23736/S1121-421X.20.02760-9","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02760-9","url":null,"abstract":"","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76613067","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 : 2020-09-01Epub Date: 2020-04-23DOI: 10.23736/S1121-421X.20.02707-5
Davide G Ribaldone, Marco Astegiano, Giovanni C Actis, Rinaldo Pellicano
{"title":"Management of inflammatory bowel disease during COVID-19 pandemic.","authors":"Davide G Ribaldone, Marco Astegiano, Giovanni C Actis, Rinaldo Pellicano","doi":"10.23736/S1121-421X.20.02707-5","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02707-5","url":null,"abstract":"","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":" ","pages":"184-186"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37866857","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 : 2020-07-16DOI: 10.23736/S1121-421X.20.02745-2
M. Pennazio, E. Rondonotti, R. Pellicano, P. Cortegoso Valdivia
Small bowel capsule endoscopy (SBCE) was introduced into clinical practice almost 20 years ago and, nowadays, it is an essential tool for the study of the small bowel. SBCE allows a radiation-free examination of the entire mucosal surface of the small bowel with high-quality images, limited invasivity and a good safety profile. Nevertheless, the main limitation of SBCE is the lack of any possible direct therapeutic intervention. Indications for SBCE have evolved throughout the years, from "old" ones such as suspected small bowel bleeding (still the main indication for SBCE) to newer ones such as refractory celiac disease, hereditary polyposis syndromes and Crohn's disease. Thus, nowadays SBCE has a key role in the diagnostic algorithms in many conditions. Furthermore, the introduction in the SBCE field of cutting-edge technologies, as artificial intelligence systems, is likely to shorten the reading time making SBCE even more effective and easy to perform. Preliminary data are extremely promising and solid evidence is being gathered by current studies.
{"title":"Small bowel capsule endoscopy: where do we stand after 20 years of clinical use?","authors":"M. Pennazio, E. Rondonotti, R. Pellicano, P. Cortegoso Valdivia","doi":"10.23736/S1121-421X.20.02745-2","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02745-2","url":null,"abstract":"Small bowel capsule endoscopy (SBCE) was introduced into clinical practice almost 20 years ago and, nowadays, it is an essential tool for the study of the small bowel. SBCE allows a radiation-free examination of the entire mucosal surface of the small bowel with high-quality images, limited invasivity and a good safety profile. Nevertheless, the main limitation of SBCE is the lack of any possible direct therapeutic intervention. Indications for SBCE have evolved throughout the years, from \"old\" ones such as suspected small bowel bleeding (still the main indication for SBCE) to newer ones such as refractory celiac disease, hereditary polyposis syndromes and Crohn's disease. Thus, nowadays SBCE has a key role in the diagnostic algorithms in many conditions. Furthermore, the introduction in the SBCE field of cutting-edge technologies, as artificial intelligence systems, is likely to shorten the reading time making SBCE even more effective and easy to perform. Preliminary data are extremely promising and solid evidence is being gathered by current studies.","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89307182","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 : 2020-07-16DOI: 10.23736/S1121-421X.20.02727-0
F. Castellano, G. Alessio, C. Palmisano
Inflammatory bowel diseases (IBD), that includes ulcerative colitis and Crohn's disease, can affect not only the gastrointestinal tract but a wide spectrum of organs. The extra-intestinal manifestations (EIMs) are one of the most challenging aspect of IBD, playing a significant role for the life-time care and the quality-life of patients. Ocular manifestations are the third most frequent EIMs, preceded by articular and dermatological ones. The aim of this narrative review is to describe the different types of ocular involvements, focusing on their clinical management. Uveitis and episcleritis are the most common ocular EIMs, differing for many aspects. Uveitis are unrelated with IBD activity and they even precede the onset of the intestinal disease, while episcleritis are common defined as a good mark of IBD activity. Pain is uncommon in most cases of episcleritis, while severe eye pain and photophobia are the most frequent onset of anterior uveitis. Less common but even more severe, are orbital pseudotumor or posterior segment involvement. Most of the ocular EIMs can be successfully treated with topic and oral steroids and the underlying therapy for IBD can reduce or cut out at all the recurrence of these manifestations. Symptoms are commonly not specific, in some cases being unnoticed for years leading to permanent ocular consequences. Cooperation between different specialists is crucial to avoid all the possible consequences of a non-treated EIMs, especially for ocular ones.
{"title":"Ocular manifestations of inflammatory bowel diseases: an update for gastroenterologists.","authors":"F. Castellano, G. Alessio, C. Palmisano","doi":"10.23736/S1121-421X.20.02727-0","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02727-0","url":null,"abstract":"Inflammatory bowel diseases (IBD), that includes ulcerative colitis and Crohn's disease, can affect not only the gastrointestinal tract but a wide spectrum of organs. The extra-intestinal manifestations (EIMs) are one of the most challenging aspect of IBD, playing a significant role for the life-time care and the quality-life of patients. Ocular manifestations are the third most frequent EIMs, preceded by articular and dermatological ones. The aim of this narrative review is to describe the different types of ocular involvements, focusing on their clinical management. Uveitis and episcleritis are the most common ocular EIMs, differing for many aspects. Uveitis are unrelated with IBD activity and they even precede the onset of the intestinal disease, while episcleritis are common defined as a good mark of IBD activity. Pain is uncommon in most cases of episcleritis, while severe eye pain and photophobia are the most frequent onset of anterior uveitis. Less common but even more severe, are orbital pseudotumor or posterior segment involvement. Most of the ocular EIMs can be successfully treated with topic and oral steroids and the underlying therapy for IBD can reduce or cut out at all the recurrence of these manifestations. Symptoms are commonly not specific, in some cases being unnoticed for years leading to permanent ocular consequences. Cooperation between different specialists is crucial to avoid all the possible consequences of a non-treated EIMs, especially for ocular ones.","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80164419","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 : 2020-07-16DOI: 10.23736/S1121-421X.20.02747-6
C. Martelletti, A. Armandi, G. P. Caviglia, G. Saracco, R. Pellicano
Focal liver lesions (FLLs) are a common finding during routine abdominal ultrasound (US). The differential diagnosis between diverse types of FLLs, especially between benign and malignant ones, is extremely important and can often be particularly challenging. Radiological techniques with contrast administration and/or liver biopsy are mostly necessary for establishing diagnosis, but they have several contraindications or complications. Due to limitations of these tools, there is urgent and still unmet need to develop a first line, non-invasive and simple method to diagnose FLLs. Elastography is an US-based imaging modality that provides information about the physical parameter corresponding to the tissue stiffness and can be considered a virtual biopsy. Several elastographic approaches have been developed, such as transient elastography, strain imaging and share wave imaging, which include point shear wave elastography and 2D shear wave elastography. These tools are already in use for evaluating liver fibrosis and in the assessment of focal lesions in other organs, like breast and thyroid gland. This review aims to assess the current evidence of different techniques based on elastography in the setting of FLLs, in order to evaluate accuracy, limitations and future perspectives. In particular, we focused on two contexts: the ability of discriminating between benign and malignant lesions, especially hepatocellular carcinoma and liver metastasis, and the surveillance after percutaneous therapy. This could have a high clinicalimpact making elastography crucial to identify the appropriate management of FLLs.
{"title":"Elastography for characterization of focal liver lesions: current evidence and future perspectives.","authors":"C. Martelletti, A. Armandi, G. P. Caviglia, G. Saracco, R. Pellicano","doi":"10.23736/S1121-421X.20.02747-6","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02747-6","url":null,"abstract":"Focal liver lesions (FLLs) are a common finding during routine abdominal ultrasound (US). The differential diagnosis between diverse types of FLLs, especially between benign and malignant ones, is extremely important and can often be particularly challenging. Radiological techniques with contrast administration and/or liver biopsy are mostly necessary for establishing diagnosis, but they have several contraindications or complications. Due to limitations of these tools, there is urgent and still unmet need to develop a first line, non-invasive and simple method to diagnose FLLs. Elastography is an US-based imaging modality that provides information about the physical parameter corresponding to the tissue stiffness and can be considered a virtual biopsy. Several elastographic approaches have been developed, such as transient elastography, strain imaging and share wave imaging, which include point shear wave elastography and 2D shear wave elastography. These tools are already in use for evaluating liver fibrosis and in the assessment of focal lesions in other organs, like breast and thyroid gland. This review aims to assess the current evidence of different techniques based on elastography in the setting of FLLs, in order to evaluate accuracy, limitations and future perspectives. In particular, we focused on two contexts: the ability of discriminating between benign and malignant lesions, especially hepatocellular carcinoma and liver metastasis, and the surveillance after percutaneous therapy. This could have a high clinicalimpact making elastography crucial to identify the appropriate management of FLLs.","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79534318","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 : 2020-07-16DOI: 10.23736/S1121-421X.20.02687-2
Marwa Hassan, T. Aboushousha, E. El-Ahwany, Heba Khalil, A. Montasser, Hoda Abu-Taleb, M. D. El-Talkawy, M. Zoheiry
BACKGROUND The mechanisms of chronic hepatitis C virus (HCV)-induced liver fibrosis and hepatocarcinogenesis are still poorly recognized. Therefore, this study aimed to determine the effect of chronic HCV infection on the expression of the major regulators of epithelialmesenchymal transition (EMT) including E-cadherin, snail, slug, and twist2, in the Egyptian population. This will help to design more efficient strategies to treat HCV-associated cirrhosis and carcinoma. METHODS Fifty-nine liver biopsies from patients, that were serologically proven to be HCV positive, were included in the current study. Histopathological examination was done. Grading of hepatitis activity (A) and staging of fibrosis (F) were assessed using the METAVIR scoring system. Additionally, an immunohistochemical examination of E-cadherin, snail, slug, and twist2 expression was performed. RESULTS E-cadherin showed a significant progressive decline of its expression with increased fibrosis staging and development of hepatocellular carcinoma (HCC). In contrast, snail and slug expression was positively associated with the stage of fibrosis and HCC. Meanwhile, twist2 expression wasn't affected by the degree of hepatitis activity, the stage of fibrosis, or by the development of HCC. CONCLUSIONS E-cadherin and its transcriptional regulators; snail and slug may serve as indicators for assessing the stage of fibrosis and the progression of HCC associated with HCV infection but not for assessing the degree of hepatitis activity. Therefore, the snail family could be a promising target for designing effective preventive and therapeutic strategies for chronic HCV infection and its serious co-morbidities.
{"title":"Impact of E-cadherin and its transcription regulators on assessing epithelial-mesenchymal transition in chronic HCV infection.","authors":"Marwa Hassan, T. Aboushousha, E. El-Ahwany, Heba Khalil, A. Montasser, Hoda Abu-Taleb, M. D. El-Talkawy, M. Zoheiry","doi":"10.23736/S1121-421X.20.02687-2","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02687-2","url":null,"abstract":"BACKGROUND\u0000The mechanisms of chronic hepatitis C virus (HCV)-induced liver fibrosis and hepatocarcinogenesis are still poorly recognized. Therefore, this study aimed to determine the effect of chronic HCV infection on the expression of the major regulators of epithelialmesenchymal transition (EMT) including E-cadherin, snail, slug, and twist2, in the Egyptian population. This will help to design more efficient strategies to treat HCV-associated cirrhosis and carcinoma.\u0000\u0000\u0000METHODS\u0000Fifty-nine liver biopsies from patients, that were serologically proven to be HCV positive, were included in the current study. Histopathological examination was done. Grading of hepatitis activity (A) and staging of fibrosis (F) were assessed using the METAVIR scoring system. Additionally, an immunohistochemical examination of E-cadherin, snail, slug, and twist2 expression was performed.\u0000\u0000\u0000RESULTS\u0000E-cadherin showed a significant progressive decline of its expression with increased fibrosis staging and development of hepatocellular carcinoma (HCC). In contrast, snail and slug expression was positively associated with the stage of fibrosis and HCC. Meanwhile, twist2 expression wasn't affected by the degree of hepatitis activity, the stage of fibrosis, or by the development of HCC.\u0000\u0000\u0000CONCLUSIONS\u0000E-cadherin and its transcriptional regulators; snail and slug may serve as indicators for assessing the stage of fibrosis and the progression of HCC associated with HCV infection but not for assessing the degree of hepatitis activity. Therefore, the snail family could be a promising target for designing effective preventive and therapeutic strategies for chronic HCV infection and its serious co-morbidities.","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82708523","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 : 2020-07-03DOI: 10.23736/S1121-421X.20.02715-4
N. Brandi, A. Parmeggiani, S. Brocchi, C. Balacchi, C. Gaudiano, R. Golfieri
Pneumatosis Intestinalis (PI) is a rare radiological finding and is defined as the presence of extra- luminal gas within the intestinal wall. PI can be distinguished in a benign form and a life-threatening form, burdened with high mortality. The correct management of PI must always take into account patient's history, his clinical context, laboratory test results and radiological findings, in order to administrate a proper therapy and avoid unnecessary surgical intervention. The pathogenesis of primary PI is still unknown and several theories have been proposed. Here, we report the case of a man with a previous severe traumatic brain injury who developed a transitory PI secondary to the enteral nutrition through a tube feeding, conservatively treated and underwent a radiological follow- up. Our report strengthens the relationship with enteral tube feeding and PI suggesting that any disaccharide used as pharmacological excipient or sweetener in the formulations for enteral tube feeding can potentially promote PI development, especially if administered in large quantities and in particular predisposing conditions. For this reason, the correct management of PI must always take into account patient's history, his clinical context, laboratory test results and radiological findings, in order to achieve a clear comprehension of its aetiology and administrate a proper therapy, avoiding unnecessary and potentially harmful surgery.
{"title":"Conservative treatment and radiological follow-up in a case of pneumatosis intestinalis associated with enteral tube feeding.","authors":"N. Brandi, A. Parmeggiani, S. Brocchi, C. Balacchi, C. Gaudiano, R. Golfieri","doi":"10.23736/S1121-421X.20.02715-4","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02715-4","url":null,"abstract":"Pneumatosis Intestinalis (PI) is a rare radiological finding and is defined as the presence of extra- luminal gas within the intestinal wall. PI can be distinguished in a benign form and a life-threatening form, burdened with high mortality. The correct management of PI must always take into account patient's history, his clinical context, laboratory test results and radiological findings, in order to administrate a proper therapy and avoid unnecessary surgical intervention. The pathogenesis of primary PI is still unknown and several theories have been proposed. Here, we report the case of a man with a previous severe traumatic brain injury who developed a transitory PI secondary to the enteral nutrition through a tube feeding, conservatively treated and underwent a radiological follow- up. Our report strengthens the relationship with enteral tube feeding and PI suggesting that any disaccharide used as pharmacological excipient or sweetener in the formulations for enteral tube feeding can potentially promote PI development, especially if administered in large quantities and in particular predisposing conditions. For this reason, the correct management of PI must always take into account patient's history, his clinical context, laboratory test results and radiological findings, in order to achieve a clear comprehension of its aetiology and administrate a proper therapy, avoiding unnecessary and potentially harmful surgery.","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75416746","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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