Intussuscepted Polypoid Meckel's Diverticulum Presenting With Gastrointestinal Bleeding in a Young Adult.

A 22-year-old female patient with a recent hospitalization for gastrointestinal bleeding presented with recurrent hematochezia and a positive shock index. Previous investigations, including endoscopy and wireless small bowel capsule, were non-diagnostic. CT angiography revealed extravasation in the ileum.

Combination of Percutaneous Transhepatic Balloon-Assisted Transjugular Intrahepatic Collateral Caval Shunt and Embolization for Successful Hemostasis of Lower Gastrointestinal Bleeding Associated With Extremely Enlarged Anorectal Varicose Veins.

Ectopic varices may frequently occur in the rectum in the context of portal hypertension. Although rectal variceal bleeding is not a frequent bleeding situation, it can be life-threatening unless diagnosed and treated immediately. However, there is no specific treatment strategy established so far.

Sweet Syndrome Associated With Crohn's Disease Developed After a Combo Therapy With Infliximab and Azathioprine: A Case Report.

Sweet syndrome, also known as Acute Febrile Neutrophilic Dermatosis, is a rare inflammatory condition. The exact pathogenesis of Sweet syndrome is unclear, however, autoimmune and inflammatory conditions including inflammatory bowel disease have been linked as underlying etiologies. Since its description, in 1964, there have been published less than fifty reports of Crohn's-associated Sweet syndrome.

Olmesartan-Induced Enteropathy: A Report of an Unusual Cause of Chronic Diarrhea.

Olmesartan, an angiotensin II receptor blocker indicated in the treatment of hypertension, has been associ-ated with a seronegative sprue-like enteropathy that should be considered in the differential diagnosis of patients with unexplained chronic diarrhoea. It typically presents with severe chronic diarrhoea, considerable weight loss, and villous atrophy on biopsy and may be difficult to recognize because of its clinical and histological similarities to other clinical entities. Practically, discontinuation of the drug leads to dramatic recovery of the symptoms.

Differentially Methylated Ultra-Conserved Regions Uc160 and Uc283 in Adenomas and Adenocarcinomas Are Associated with Overall Survival of Colorectal Cancer Patients.

Deregulation of the transcribed ultra-conserved regions (T-UCRs) Uc160, Uc283, and Uc346 has been reported in colorectal cancer (CRC) recently. Here, we investigated promoter methylation of these T-UCRs during the adenoma-carcinoma sequence and their clinical significance in CRC patients. Methylation levels were assessed in CRC, adenomas, infiltrated lymph nodes, and metastatic tissue specimens.

Expression of α-Defensins, CD20+ B-lymphocytes, and Intraepithelial CD3+ T-lymphocytes in the Intestinal Mucosa of Patients with Liver Cirrhosis: Emerging Mediators of Intestinal Barrier Function.

Aim: The present study investigates the role of innate and adaptive immune system of intestinal mucosal barrier function in cirrhosis.

Methods: Forty patients with decompensated (n = 40, group A), 27 with compensated cirrhosis (n = 27, group B), and 27 controls (n = 27, group C) were subjected to duodenal biopsy. Expression of α-defensins 5 and 6 at the intestinal crypts was evaluated by immunohistochemistry and immunofluorescence.

Propranolol reduces systemic oxidative stress and endotoxemia in cirrhotic patients with esophageal varices.

Background: The aim of the study was to investigate the effect of propranolol on systemic oxidative stress and endotoxemia in patients with liver cirrhosis and clinically significant portal hypertension evidenced by the presence of esophageal varices.

Methods: Fourteen patients with liver cirrhosis and esophageal varices, not previously been treated with non-selective beta-blockers (NSBB), were prospectively started on propranolol and followed up for three months. Serum early and late lipid peroxidation products (lipid hydroperoxides [LOOH] and malondialdehyde [MDA], respectively), and endotoxin concentrations in peripheral blood were measured.

Patient Radiation Doses in Therapeutic Endoscopic Retrograde Cholangiopancreatography in Patras and the Key Role of the Operator.

The patient radiation doses, in conjunction with the operator experience, in therapeutic endoscopic retrograde cholangiopancreatography (ERCP) procedures, performed in our hospital, were obtained. Ninety-six patients participated in the study and were divided into 3 groups, based on the operator experience. The dosemetric indices, fluoroscopy time (FT), cumulative dose (Ka,r) and air kerma-area product (PKA), were collected.

OPTIMISATION OF PATIENT DOSE AND IMAGE QUALITY IN ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY: A PHANTOM-BASED EVALUATION.

A phantom-based study is presented aiming to optimise patient dose and image quality (IQ) in endoscopic retrograde cholangiopancreatography procedures, utilising a fluoroscopy system equipped with a flat panel detector. The patient thickness was simulated with various polymethyl methacrylate slabs, whilst IQ was evaluated using the Leeds test object. The main factors evaluated were phantom thickness, distance between phantom and detector, field of view and pulse rate.

PATIENT DOSE DURING THERAPEUTIC ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY PROCEDURE.

Endoscopic retrograde cholangiopancreatography (ERCP) is a standard technique for the diagnosis and treatment of disorders of the pancreas or bile ducts. The aim of this study was the measurement of the radiation dose to patients during therapeutic ERCP procedures, in order to estimate the patient effective dose (ED). Fifteen patients were studied using a fluoroscopy system equipped with automatic brightness control and pulse fluoroscopy mode.

Intestinal barrier dysfunction in cirrhosis: Current concepts in pathophysiology and clinical implications.

The intestinal lumen is a host place for a wide range of microbiota and sets a unique interplay between local immune system, inflammatory cells and intestinal epithelium, forming a physical barrier against microbial invaders and toxins. Bacterial translocation is the migration of viable or nonviable microorganisms or their pathogen-associated molecular patterns, such as lipopolysaccharide, from the gut lumen to the mesenteric lymph nodes, systemic circulation and other normally sterile extraintestinal sites. A series of studies have shown that translocation of bacteria and their products across the intestinal barrier is a commonplace in patients with liver disease.

Intestinal mucosal proliferation, apoptosis and oxidative stress in patients with liver cirrhosis.

Background: Intestinal mucosal barrier dysfunction in liver cirrhosis and its implicated mechanisms is of great clinical importance because it is associated with the development of serious complications from diverse organs through promotion of systemic endotoxemia.

Aim: The present study was designed to investigate whether enterocytes' proliferation, apoptosis and intestinal oxidative stress are altered in the intestinal mucosa of patients with compensated and decompensated liver cirrhosis.

Material And Methods: Twelve healthy controls (group A) and twenty four cirrhotic patients at a compensated (n = 12, group B) or decompensated condition (n = 12, group C) were subjected to duodenal biopsy.

Altered intestinal tight junctions' expression in patients with liver cirrhosis: a pathogenetic mechanism of intestinal hyperpermeability.

Background: Increased intestinal permeability in cirrhosis exerts a pivotal role in the pathogenesis of spontaneous bacterial peritonitis and other complications of cirrhosis through promotion of systemic endotoxemia. This study was designed to investigate whether the expression of tight junction (TJ) proteins, which regulate gut paracellular permeability, is altered in the intestinal mucosa of patients with liver cirrhosis and study its potential association with the stage of liver disease and the development of systemic endotoxemia.

Design: Twenty-four patients with cirrhosis at a decompensated (n = 12, group A) or compensated condition (n = 12, group B) and 12 healthy controls (group C) were subjected to duodenal biopsy.

Intestinal epithelial cell proliferation, apoptosis and expression of tight junction proteins in patients with obstructive jaundice.

Background: Intestinal hyperpermeability has been repeatedly confirmed in patients with obstructive jaundice and is considered a pivotal factor in the development of septic and renal complications in these patients. However, little is known on the mechanism(s) leading to this phenomenon. This study was undertaken to investigate the cellular and subcellular intestinal alterations in patients with obstructive jaundice.

Pentoxifylline: a first line treatment option for severe alcoholic hepatitis and hepatorenal syndrome?

Although favourable results of pentoxifylline (PTX) used in treatment of severe alcoholic hepatitis patients with a Maddrey discriminant function score > or = 32 have been previously reported, it is not currently recommended as a first line treatment for alcoholic hepatitis owing to lack of evidence for its efficacy as compared to the standard treatment with corticosteroids. In a very recent issue of World Journal of Gastroenterology, Dr. De BK and colleagues compared for the first time the two treatment modalities head to head in a randomized controlled study, demonstrating the advantage of PTX over corticosteroids in terms of patients' survival and risk-benefit profile.

Management of Αcute Non-Variceal Upper Gastrointestinal Bleeding: Drugs, Endoscopic Hemostasis, or Both?

Acute upper gastrointestinal bleeding remains one of the most frequent and emergent conditions in everyday clinical practice and a challenge for doctors. Peptic ulcer is responsible for more than half of acute upper gastrointestinal bleeding and is the most frequent cause of serious non-variceal bleeding. Despite progress in diagnosis and management in these patients, the recurrence of bleeding remains an important problem.

Increased Plasma Superoxide Radical in Patients with Non-Metastatic Colorectal Cancer.

Background: Several studies have investigated the potential role of oxidative stress in the evolution of colorectal cancer. In most of these studies, oxidative stress was assessed indirectly by measurements of indices like lipid peroxidation, protein oxidation or antioxidant status. The present study was undertaken to directly assess systemic oxidative stress by measuring plasma superoxide radical (O·) in patients with non-metastatic colorectal cancer.

Plasma superoxide radical in jaundiced patients and role of xanthine oxidase.

Background: In the experimental setting, obstructive jaundice induces oxidative stress in several extrahepatic tissues (systemic phenomenon), which is at least partly attributed to activation of the enzyme xathine oxidase. Very little is known on this important issue in patients with cholestasis. The present study was designed to (a) assess directly oxidative stress in the blood of patients with obstructive jaundice by measuring superoxide radical, and (b) investigate ex vivo whether xanthine oxidase (XO) is the source of this radical.

Changes in indications for upper gastrointestinal tract endoscopy and endoscopic findings during the last fifteen years in south-western Greece.

Background: During the past years, major advances in the management of upper gastrointestinal diseases have been achieved. The aim of this study was to determine if changes in indications for upper gastrointestinal endoscopy and endoscopic findings have occurred during the last 15 years in our area.

Methods: Indications for upper gastrointestinal tract endoscopy and endoscopy findings of patients who underwent upper endoscopy in years 1990, 1995, 2000, and 2005 in our department were compared.

Acute upper gastrointestinal bleeding in octogenarians: clinical outcome and factors related to mortality.

Aim: To evaluate the aetiology, clinical outcome and factors related to mortality of acute upper gastrointestinal bleeding (AUGIB) in octogenarians.

Methods: We reviewed the records of all patients over 65 years old who were hospitalised with AUGIB in two hospitals from January 2006 to December of 2006. Patients were divided into two groups: Group A (65-80 years old) and Group B (>80 years old).