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Revista Espanola de Enfermedades... Oct 2023A 35-year old male from Brazil presented with intermittent abdominal pain. Abdominal computed tomography revealed a nodule adjacent to splenic hilum and multiple...
A 35-year old male from Brazil presented with intermittent abdominal pain. Abdominal computed tomography revealed a nodule adjacent to splenic hilum and multiple abdominal nodules, suspicious of carcinomatosis. The patient underwent gastroscopy and endoscopic ultrasound (EUS), that revealed an ill-defined hypoechogenic lesion adjacent to the spleen and two hypoechogenic subepithelial lesions located in the 4th layer of the stomach and duodenal bulb. Biopsies revealed non-necrotizing granulomatous inflammation with multinucleated giant cells. Soon after, a 18cm palpable mass within the rectus abdominis muscle was identified, and the biopsy was positive for Mycobacterium tuberculosis DNA, confirming the diagnosis of disseminated abdominal tuberculosis.
Topics: Male; Humans; Adult; Tuberculosis; Abdomen; Spleen; Stomach; Gastroscopy
PubMed: 37539521
DOI: 10.17235/reed.2023.9855/2023 -
BMC Gastroenterology Apr 2024Endoscopic features of intestinal transplant-associated microangiopathy (iTAM) have not been comprehensively investigated. This study aimed to examine the endoscopic...
BACKGROUND
Endoscopic features of intestinal transplant-associated microangiopathy (iTAM) have not been comprehensively investigated. This study aimed to examine the endoscopic characteristics of patients diagnosed with iTAM.
METHODS
This retrospective analysis included 14 patients pathologically diagnosed with iTAM after stem cell transplantation for hematolymphoid neoplasms (n = 13) or thalassemia (n = 1). The sex, age at diagnosis, endoscopic features, and prognosis of each patient were assessed. Serological markers for diagnosing transplant-associated thrombotic microangiopathy were also evaluated.
RESULTS
The mean age at the time of iTAM diagnosis was 40.2 years. Patients diagnosed based on the pathognomonic pathological changes of iTAM presented with diverse symptoms at the times of endoscopic examinations, including diarrhea (n = 10), abdominal pain (n = 5), nausea (n = 4), appetite loss (n = 2), bloody stools (n = 2), abdominal discomfort (n = 1), and vomiting (n = 1). At the final follow-up, six patients survived, while eight patients succumbed, with a median time of 100.5 days (range: 52-247) post-diagnosis. Endoscopic manifestations included erythematous mucosa (n = 14), erosions (n = 13), ulcers (n = 9), mucosal edema (n = 9), granular mucosa (n = 9), and villous atrophy (n = 4). Erosions and/or ulcers were primarily observed in the colon (10/14, 71%), followed by the ileum (9/13, 69%), stomach (4/10, 40%), cecum (5/14, 36%), duodenum (3/10, 30%), rectum (4/14, 29%), and esophagus (1/10, 10%). Cytomegalovirus infection (n = 4) and graft-versus-host disease (n = 2) coexisted within the gastrointestinal tract. Patients had de novo prolonged or progressive thrombocytopenia (6/14, 43%), decreased hemoglobin concentration (4/14, 29%), reduced serum haptoglobin level (3/14, 21%), and a sudden and persistent increase in lactate dehydrogenase level (2/14, 14%). Peripheral blood samples from 12 patients were evaluated for schistocytes, with none exceeding 4%.
CONCLUSIONS
This study provides a comprehensive exploration of the endoscopic characteristics of iTAM. Notably, all patients exhibited erythematous mucosa throughout the gastrointestinal tract, accompanied by prevalent manifestations, such as erosions (93%), ulcers (64%), mucosal edema (64%), granular mucosa (64%), and villous atrophy (29%). Because of the low positivity for serological markers of transplant-associated thrombotic microangiopathy in patients with iTAM, endoscopic evaluation and biopsy of these lesions are crucial, even in the absence of these serological features.
Topics: Humans; Male; Female; Adult; Retrospective Studies; Middle Aged; Thrombotic Microangiopathies; Young Adult; Intestinal Mucosa; Endoscopy, Gastrointestinal; Adolescent; Hematologic Neoplasms; Stem Cell Transplantation; Intestinal Diseases; Diarrhea; Hematopoietic Stem Cell Transplantation; Aged
PubMed: 38649868
DOI: 10.1186/s12876-024-03221-y -
Frontiers in Cellular and Infection... 2023Enterotoxigenic (ETEC), an important intestinal pathogen, poses a significant threat to the intestinal health of piglets. (BC), a potential feed additive, can improve...
BACKGROUND
Enterotoxigenic (ETEC), an important intestinal pathogen, poses a significant threat to the intestinal health of piglets. (BC), a potential feed additive, can improve the intestinal function of piglets. However, the effects of BC on growth performance and intestinal function in ETEC-infected piglets are still unclear. In this study, 24 7-day-old piglets were randomly assigned to three treatment groups: control group (fed a basal diet), ETEC group (fed a basal diet and challenged with ETEC K88) and BC+ETEC group (fed a basal diet, orally administered BC, challenged with ETEC K88). During Days 1-6 of the trial, piglets in the BC+ETEC group were orally administered BC (1×10CFU/kg). On Day 5 of the trial, piglets in the ETEC and BC+ETEC groups were orally administered ETEC K88 (5×10CFU/piglet). Blood, intestinal tissue, and content samples were collected from the piglets on Day 7 of the trial.
RESULTS
The average daily feed intake in the ETEC group was significantly reduced compared to that of the control group. Further research revealed that ETEC infection significantly damaged the structure of the small intestine. Compared to the control group, the villus height and surface area of the jejunum, the ratio of villus height to crypt depth in the duodenum and jejunum, and the activities of catalase and total superoxide dismutase in the jejunum were significantly reduced. Additionally, the levels of myeloperoxidase in the jejunum, malondialdehyde in the plasma and jejunum, and intestinal epithelial apoptosis were significantly increased in the ETEC group. However, BC supplementation had significantly mitigated these negative effects in the BC+ETEC group by Day 7 of the trial. Moreover, BC supplementation improved the gut microbiota imbalance by reversing the decreased numbers of , and in jejunum and , and in the colon, as well as the increased number of in the jejunum induced by ETEC K88.
CONCLUSIONS
Overall, BC supplementation reduced the decline in average daily feed intake in ETEC K88-infected piglets by attenuating intestinal epithelial apoptosis and oxidative stress and regulating the gut microbiota. This suggests that BC may be used to prevent intestinal infections caused by ETEC in piglets.
Topics: Animals; Bacillus coagulans; Eating; Enterotoxigenic Escherichia coli; Escherichia coli Infections; Gastrointestinal Microbiome; Intestines; Swine; Swine Diseases
PubMed: 38035331
DOI: 10.3389/fcimb.2023.1284166 -
JGH Open : An Open Access Journal of... May 2024represents the major pathogen in the pathophysiology of diverse gastrointestinal conditions. This study sought to determine the endoscopic aspect of the gastric mucosa...
Endoscopic mucosal phenotypes and endoscopic Sydney system gastritis assessment in relation to infection and upper digestive clinical signs: A 2-year study among patients with gastroduodenal disorders in Cameroon.
BACKGROUND AND AIM
represents the major pathogen in the pathophysiology of diverse gastrointestinal conditions. This study sought to determine the endoscopic aspect of the gastric mucosa in relation to infection in Cameroon.
METHODS
This study was conducted in three reference health facilities in Cameroon from October 2020 to October 2022. The study enrolled 494 consecutive volunteer dyspeptic patients attending to the gastroenterology department of the selected health facilities. A description of the aspect of gastric mucosa of all participants was performed during endoscopy examination, and biopsies were collected for detection using rapid urease tests.
RESULTS
Gastritis, ulcerated lesions, duodenitis, esophagitis, normal mucosa aspect, bulbitis, and gastric neoplastic lesions were found in 40.1, 22.3, 10.9, 10.3, 9.7, 6.3, and 0.40% of biopsy samples, respectively. Erythematous/exudative (45.9%) and enterogastric reflux (12.2%) were the main gastritis types recorded. was present in 58.1, 46.3, 87.1, 66.7, and 61.8% in gastritis, duodenitis, bulbitis, esophagitis, and ulcerated lesions, respectively. A positive relationship was noticed between the presence of and gastritis (1.037 [0.720-1.493]; = 0.845), bulbitis (4.237 [1.602-11.235]; = 0.004), esophagitis (1.515 [0.822-2.793]; = 0.183), ulcerated lesions (1.233 [0.798-1.904]; = 0.345), erythematous/exudative gastritis (1.354 [0.768-2.389]; = 0.295), and enterogastric reflux gastritis (1.159 [0.492-2.733]; = 0.736).
CONCLUSION
Gastritis and erythematous/exudative gastritis are the most frequent gastrointestinal pathophysiology conditions in dyspeptic patient in our milieu. infection is responsible for 94.8% of the gastrointestinal pathophysiology conditions with bulbitis as the condition is significantly associated with this bacterium infection.
PubMed: 38725943
DOI: 10.1002/jgh3.13060 -
International Journal of Surgery Case... Sep 2023Amoeboma is a pseudotumoral presentation of amebiasis which is a parasitic infection caused by entamoeba histolytica. Its location in the gallbladder is extremely rare....
INTRODUCTION AND IMPORTANCE
Amoeboma is a pseudotumoral presentation of amebiasis which is a parasitic infection caused by entamoeba histolytica. Its location in the gallbladder is extremely rare. Indeed, only one other case was found in the literature. Therefore, we present this case report on managing a gallbladder amoeboma mimicking a cholangiocarcinoma.
CASE PRESENTATION
A 62-year-old presenting for consultation for biliary colic that has been developing for 4 months without associated signs. MRI and thoraco-abdominal CT concluded to a cholangiocarcinoma of the gallbladder extended to the liver with probable localized peritoneal carcinosis. We, therefore, performed extended cholecystectomy with lymphadenectomy for the diagnosis of cholangiocarcinoma. Pathology concluded to an amoeboma of the gallbladder extended to the liver and duodenum.
CLINICAL DISCUSSION
To our knowledge, there is only one case of gallbladder amoeboma in the literature making this case report valuable. It is important to draw lessons of this observation. Indeed, in front of the discrepancy between the clinic, biology (good general condition and negative tumor markers) and the imaging, we prefer this therapeutic strategy: make a biopsy of the hepatic parenchyma, realize amoebic serology to confirm the diagnosis. Then subject the patient to a therapeutic test based on metronidazole and confirm the disappearance of suspicious lesions by CT scan.
CONCLUSION
Gallbladder amoeboma is an exceptional entity, but it needs to be kept in mind in case of an atypical presentation of a cholangiocarcinoma. Evoking and confirming the diagnosis preoperatively makes it possible to avoid excessive surgery.
PubMed: 37579627
DOI: 10.1016/j.ijscr.2023.108656 -
JPGN Reports Nov 2023Pediatric infection represents a small proportion of disease that is otherwise decreasing in the developed world. Typical presentations have been well-described in the...
Pediatric infection represents a small proportion of disease that is otherwise decreasing in the developed world. Typical presentations have been well-described in the literature. We report a 15-year-old male who presented with jaundice, anemia, dark urine, and poorly characterized abdominal pain and was found to have obstructive jaundice secondary to a duodenal ulcer resulting from infection. Obstructive jaundice is a seldom reported complication of duodenal ulcer, particularly in children. This report reviews infection, outlines complications of peptic ulcer disease, and illustrates the rarity of obstructive jaundice as a presenting sign of duodenal ulcer in children.
PubMed: 38034451
DOI: 10.1097/PG9.0000000000000348 -
The Medical Journal of Malaysia Dec 2023Novel coronavirus 19 disease (COVID-19) pandemic poses healthcare providers challenges in the endoscopic suite. It is unclear whether it affects the endoscopic...
INTRODUCTION
Novel coronavirus 19 disease (COVID-19) pandemic poses healthcare providers challenges in the endoscopic suite. It is unclear whether it affects the endoscopic manifestations of upper gastrointestinal (GI) bleeding. This retrospective study was done to review demographic data, site of lesions and need of interventions for those lesions.
MATERIALS AND METHODS
Oesophagoduodenoscopy (OGDS) reports of COVID-19 patients with indication of upper GI bleeding from March 2021 to April 2022 were reviewed. Data of 35 patients were then analysed.
RESULTS
Of the 35 patients, 8.6% (n = 3) were female and 91.4% (n = 32) were males. A total of 31.4% (n = 11) were below 50 years and 68.6% (n = 24) were 50 and above. 34.3% (n = 12) with lesions requiring endoscopic intervention, 34.3% (n = 12) with lesions not requiring endoscopic intervention, 31.4% (n = 11) has no significant stigmata of recent haemorrhage. Among subgroup requiring endoscopic intervention, 50% (n = 6) are non-variceal bleeding (NVUIB), and 50% (n = 6) are variceal bleeding (VUGIB). Among NVUGIB, 16.7% (n = 1) is gastric and duodenal angiodysplasia requiring argon plasma coagulation, 50% (n = 3) are duodenal F2A ulcer requiring thermoablation, 16.7% (n = 1) is gastric F2A ulcer requiring hemoclip, and 16.6% (n = 1) is Cameron's ulcer requiring hemoclip. Among VUGIB, 100% (n = 6) are oesophageal varices requiring endoscopic variceal banding (EVL).
CONCLUSIONS
Lower proportion of NVUGIB among COVID-19 patients raises hypothesis on whether prothrombotic state of COVID-19 is a protective factor of NVUGIB. Studies with larger sample size are needed to establish significance.
Topics: Female; Humans; Male; COVID-19; Demography; Duodenal Ulcer; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Retrospective Studies; Stomach Ulcer; Ulcer; Adult; Middle Aged; Aged
PubMed: 38159924
DOI: No ID Found -
Indian Journal of Pathology &... Jun 2024Helicobacter pylori (H. pylori) colonization affects the gastric microbiome, causing gastrointestinal (GI) diseases. Modern sequencing technology provides insights into...
BACKGROUND/AIM
Helicobacter pylori (H. pylori) colonization affects the gastric microbiome, causing gastrointestinal (GI) diseases. Modern sequencing technology provides insights into GI microbe interaction with H. pylori and their metabolic pathways in causing GI diseases. We aim to compare the gastric microbiota alteration due to H. pylori infection in patients suffering from GI diseases.
MATERIALS AND METHODS
Genomic DNA were isolated from gastric antrum tissue from 37 H.pylori-infected patients diagnosed with GERD, duodenal ulcers, and gastritis. We conducted the genomic library preparation and sequencing of the amplified product using 16S rRNA NGS analysis. Using microbiome analyst tool diversity analysis, random forest analysis and ANOVA were conducted to find out the comparison of microbial abundance. We have also conducted functional pathway prediction analysis using PICRUSt.
RESULTS
Metagenomic analysis shows high bacterial diversity in H. pylori-positive gastritis patients. Streptococcus infantis and Neisseria subflava were significantly higher in duodenal ulcer (DU) and gastritis groups. Acinetobacter lwoffii and Helicobacter pullorum were significantly high in the gastritis group only. The functional metabolic pathway analyses revealed that gastroesophageal reflux disease (GERD) samples were significantly enriched with the energy metabolism and xenobiotic biodegradation and metabolism pathways, whereas fructose-1,6-bisphosphatase III was found less in gastritis and DU groups.
CONCLUSION
There is a difference in microbiota composition in different disease outcomes. We found positive association between microbial diversity and H. pylori in gastritis group only, whereas negative association was found in DU and GERD groups. The functional metabolic pathway analysis revealed significant differences in various disease outcomes.
PubMed: 38847202
DOI: 10.4103/ijpm.ijpm_1015_23 -
Translational Animal Science 2024During the bacterial selection, isolate PF9 demonstrated tolerance to low pH and high bile salt and an ability to extend the lifespan of infected with enterotoxigenic...
During the bacterial selection, isolate PF9 demonstrated tolerance to low pH and high bile salt and an ability to extend the lifespan of infected with enterotoxigenic (; < 0.05). Thirty-two weaned piglets susceptible to ETEC F4 were randomly allocated to four treatments as follows: 1) non-challenged negative control group (; basal diet and piglets gavaged with phosphate-buffered saline), 2) negative control group (; basal diet and piglets challenged with ETEC F4, 3 × 10 CFU per pig), 3) positive control (; basal diet + 80 mg·kg of avilamycin and piglets challenged with ETEC F4), and 4) probiotic candidate (PF9; control basal diet + 2.5 × 10 CFU·kg diet of PF9 and piglets challenged with ETEC F4). The infection of ETEC F4 decreased average daily gain and gain:feed in the NC group when compared to the NNC group ( < 0.05). The inoculation of ETEC F4 induced severe diarrhea at 3 h postinoculum (), 36, 40 hpi in the NC group when compared to the NNC group ( < 0.05). The supplementation of PF9 significantly relieved diarrhea severity at 3 hpi when compared to the NC group ( < 0.05). The inoculation of ETEC F4 reduced duodenal, jejunal, and ileal villus height () in the NC group when compared to the NNC group. A significant ( < 0.05) decrease was detected in the duodenal VH in the PC and NNC groups. Moreover, the NNC group had a reduced relative mRNA level of Na-glucose cotransporter 1 () when compared to the NC group ( < 0.05). Compared to the NC and NNC groups, the supplementation of PF9 increased the relative mRNA levels of aminopeptidase N, occludin, zonula occludens-1, and SGLT1 ( < 0.05). The supplementation of PF9 also significantly increased the relative mRNA level of excitatory amino acid transporter 1 when compared to the NC group ( < 0.05). Piglets supplemented with PF9 showed lower relative abundance of Bacteroidetes in the colon than piglets from the NNC group ( < 0.05). The NNC group had a higher relative abundance of Firmicutes in the ileum than all the challenged piglets ( < 0.05); however, a lower relative abundance of Proteobacteria in the ileum and colon was observed in the NC group ( < 0.05). This study provides evidence that PF9 has the potential to improve the gut health of piglets under challenging conditions.
PubMed: 38665217
DOI: 10.1093/tas/txae050 -
Medicine Feb 2024Retroperitoneal hematomas are relatively common in patients undergoing nephrectomy. Herein, we report an unusual case involving a giant retroperitoneal hematoma and...
RATIONALE
Retroperitoneal hematomas are relatively common in patients undergoing nephrectomy. Herein, we report an unusual case involving a giant retroperitoneal hematoma and subsequent duodenal ulcerative bleeding following a radical nephrectomy.
PATIENT CONCERNS
A 77-year-old woman was admitted to our hospital for lower back pain, and she had severe right hydronephrosis and a urinary tract infection.
DIAGNOSES
The patient was diagnosed and confirmed as high-grade urothelial carcinoma.
INTERVENTIONS
After ineffective conservative treatments, a right radical nephrectomy and ureteral stump resection were performed. The patient received proton pump inhibitors to prevent stress ulcer formation and bleeding. On the first day post-surgery, she had normal gastrointestinal (GI) endoscopy findings. On the second day post-surgery, abdominal computed tomography revealed a retroperitoneal hematoma. Notably, 14 days post-surgery, massive GI bleeding occurred, and GI endoscopy identified an almost perforated ulcer in the bulbar and descending duodenum.
OUTCOMES
The patient died on day 15 after surgery.
LESSONS
Duodenal ulceration and bleeding might occur following a retroperitoneal hematoma in patients treated with nephrectomy. Timely intervention may prevent duodenal ulcers and complications, and thus could be a promising life-saving intercession.
Topics: Female; Humans; Aged; Ulcer; Carcinoma, Transitional Cell; Urinary Bladder Neoplasms; Duodenum; Gastrointestinal Hemorrhage; Hematoma; Duodenal Ulcer; Nephrectomy; Peritoneal Diseases
PubMed: 38306569
DOI: 10.1097/MD.0000000000033765