Somatization Mediates the Relationship Between Childhood Trauma and Pain Ratings in Patients with Irritable Bowel Syndrome.

Goals: To identify potential mechanisms by which childhood trauma may lead to the adult development of abdominal symptoms in patients with irritable bowel syndrome (IBS).

Background: Patients with IBS frequently report a history of childhood trauma. The pathophysiology by which abdominal pain arises in patients with IBS is multidimensional, consisting of both peripheral factors, such as altered motility, inflammation, and bacterial overgrowth, as well as central factors, such as psychological distress and neuro-hormonal dysregulation.

A Unique Approach to Obtaining Tissue in a Difficult to Access Indeterminate Biliary Stricture: Percutaneous Cholangioscopy and Biopsy.

When evaluating biliary strictures, establishing a diagnosis can present challenges. The first-line approach of endoscopic retrograde cholangiopancreatography can often involve anatomic restrictions. Traditionally, percutaneous transhepatic cholangioscopy has been the answer for biopsies unable to be obtained with the modalities above but requires time for large tract dilation and days of sinus tract maturation to allow for a scope.

Pancreatic Cystic Neoplasms: Diagnosis and Management.

Pancreatic cancer is one of the most lethal cancers, largely related to the difficulties with early detection, as it typically presents in later stages. Pancreatic cystic neoplasms (PCN) are commonly diagnosed as incidental findings on routine imaging. PCN is becoming more frequently detected with the increasing ease and frequency of obtaining cross-sectional images.