Safe and effective short-time percutaneous cholecystostomy: A retrospective observational study.

The introduction of percutaneous cholecystostomy (PCT) has shifted the paradigm in treatment of acute calculous and acalculous cholecystitis. PCT has high success and low complication rates, but there are still unresolved issues regarding the duration of the procedure. The aim of our study is to determine the characteristics and outcome of patients treated with short-term PCT drainage.

Case report: successful endoscopic treatment of a large bowel perforation caused by chicken bone ingestion.

Rationale: Large bowel perforations by a foreign body are rarely diagnosed pre-operatively due to non-specific clinical symptoms. The safety and efficacy of foreign body removal via upper endoscopy is well-established and strongly recommended. There is far less experience of endoscopic treatment of sharp foreign bodies impacted in lower parts of gastrointestinal tract.

The prevalence of celiac disease in patients with geographic tongue.

Background: Geographic tongue (GT) is a benign inflammatory condition usually involving the dorsal surface and lateral borders of the tongue. Numerous etiological factors of GT have been suggested, including immunological factors; genetic; atopic or allergic predisposition; emotional stress; and hormonal disturbances. GT may also coexist as one of the possible manifestations of celiac disease (CD).

Increased prevalence of celiac disease in patients with oral lichen planus.

Objectives: The aim of this study was to establish the prevalence of celiac disease (CD) in patients with erosive and reticular form of oral lichen planus (OLP) compared to healthy controls.

Materials And Methods: Tissue transglutaminase antibodies (anti-tTG) and antibodies against gliadin (AGA) were measured in the sera from 56 OLP patients and 57 healthy controls, who also underwent human leukocyte antigen (HLA) typing. The duodenal biopsy was performed in patients with positive serology, and a gluten-free diet was recommended if CD was confirmed.

[Croatian guidelines for diagnostics and treatments of Helicobacter pylori infection].

In the past 30-year period of investigations, the crucial role of Helicobacter pylori in chronic gastritis, gastric and duodenal ulcer development, and subsequently in gastric cancer and MALT lymphoma pathogenesis, has been recognized. During the first meeting of European Helicobacter Study Group in 1996 in Maastricht, the first recommendations for diagnostics and treatments of Helicobacter pylori infection were published, later reviewed in 2000, 2007 and 2010. The first meeting of Croatian doctors focusing on the same topics, but suitable to specific national circumstances, was held as early as 1998.

[Side effects and contraindications for biological therapy in inflammatory bowel disease].

TNF-alpha blockers side effects vary according to the frequency and severity and mainly include immunogenicity (ability to cause immune reactions), infections, malignancies, heart failure, demyelinating disease and others. Treatment with TNF-alpha blockers may result in the formation of autoantibodies and, rarely, in the development of a lupus-like syndrome. They should not be administered to patients who have experienced a severe hypersensitivity reaction.

[Croatian consensus on the treatment of inflammatory bowel diseases with biologic therapy].

Introduction of biologic therapy in clinical practice represented significant progress in the treatment of inflammatory bowel diseases (IBD) because of its proven efficacy and due to the fact that biologics are the first drugs used in the treatment of IBD that can change the natural course of this diseases. At the same time, biologics are very expensive drugs with complex mechanism of action and important side effects and their use requires evidence-based clinical guidelines. These were the reasons that Referral Center of the Croatian Ministry of Health for IBD and the IBD Section of the Croatian Society of Gastroenterology organised Croatian consensus conference that defined guidelines for the treatment of IBD with anti-TNF drugs.

Colonoscopic Polypectomies and Recommendations on the Colonoscopy Follow-up Intervals Depending on Endoscopic and Histopathological Findings.

The Aim: To show histopathological diagnoses after colonoscopic polypectomy in the University Hospital Center (KBC) Split with recommendations on further follow-up colonoscopy depending on the endoscopic and histological findings.

Patients And Methods: The study included 2842 patients who underwent colonoscopy in a two-year period (2008-2009), followed by a detailed analysis of 350 patients in which one or more polyps were simultaneously removed and 163 patients who were only sampled for histological analysis. Patients from the National Program for Colorectal Cancer Prevention and patients in which colonoscopy is indicated as part of daily outpatient or inpatient treatment were included as well.

Peutz-Jeghers syndrome complicated with intussusception: enteroscopic polyps resections through laparotomy.

Peutz-Jeghers syndrome is an autosomal dominant inherited disorder characterized by intestinal hamartomatous polyps in association with mucocutaneous pigmentations. Here we present a case of a 30-year-old woman who was hospitalized and underwent diagnostic procedures because of crampy abdominal pain. Physical examination on admission revealed pigmented spots around lips and on the oral mucosa.

Successful endoscopic removal of a lighter swallowed 17 months before.

The majority of ingested foreign bodies will pass safely through the gastrointestinal tract, but long and rigid foreign bodies are associated with an increased risk of gastrointestinal impaction, perforation and bleeding. However, large foreign bodies which have been swallowed can remain trapped in the stomach over a longer period of time without any significant symptoms. This case report describes the case of a 36-year-old man addicted to heroin who purposefully swallowed a lighter (double wrapped in cellophane) and presented with hematemesis and melena 17 months after the ingestion of the foreign body.

First Croatian transvaginal laparoscopically assisted cholecystectomies.

Background/aims: The aim of this study was to determine the feasibility and technical aspects of a new endoluminal surgical procedure: transvaginal laparoscopically assisted endoscopic cholecystectomy.

Methodology: Three female patients underwent transvaginal laparoscopically assisted endoscopic cholecystectomy (aged 40, 61 and 33 years). Pneumoperitoneum was created through a 5mm supraumbilical incision.

Interleukins IL-33 and IL-17/IL-17A in patients with ulcerative colitis.

Background/aims: Disturbance of immune homeostasis in ulcerative colitis (UC) is related to the predominance of T-helper-2 (Th2) immune response. Interleukin (IL)-33 stimulates Th lymphocytes to produce Th2 cytokines, such as IL-4, IL-5, and IL-13, which are believed to induce pathological changes in the intestinal mucosa. The pro-inflammatory role of IL-17 in UC is still unclear.

[Frequency and characteristics of dyspepsia in coronary artery disease patients].

The aim of the study was to determine the frequency of functional and organic dyspepsia and possible predictors for organic dyspepsia in coronary artery disease (CAD) patients. The 150 patients (109 men; mean age 62.61 +/- 10.

[Croatian guidelines for use of enteral nutrition in Crohn's disease].

Nutrition has an important role in the management of inflammatory bowel disease (IBD), especially in patients with Crohn's disease (CD). This role includes the prevention and correction of malnutrition, the prevention of osteoporosis and the promotion of optimal growth and development in children. In active Crohn's disease, nutritional therapy (in the form of enteral feeding) is an effective primary therapy for pediatric patients.

Use of modified multidetector CT colonography for the evaluation of acute and subacute colon obstruction caused by colorectal cancer: a feasibility study.

Purpose: This study was designed to evaluate the feasibility of using CT colonography with a modified procedural protocol for diagnosis and cancer staging in patients with suspected acute or subacute colon obstruction caused by colorectal cancer.

Methods: Following colonic cleansing with lukewarm water enemas, thin-collimation CT colonography was performed on 47 patients (15 women and 32 men, mean age, 68 years) in the precontrast prone position and in the supine position after the intravenous administration of a contrast agent. The surgical and pathologic findings served as a reference standard.

The association between upper gastrointestinal lesions and high-sensitivity C-reactive protein in coronary artery disease patients.

Background: Although high-sensitivity C-reactive protein (hs-CRP) testing is not specific for coronary atherosclerosis, elevated hs-CRP is recently accepted as an independent predictor of future cardiovascular events. Also, a connection between upper gastrointestinal lesions (UGILs) and coronary artery disease (CAD) has been observed. The authors hypothesized that UGILs increase hs-CRP in CAD patients.

Massive gastrointestinal bleeding and obstruction of the ureter caused by the migration of a swallowed toothpick from the sigmoid colon--a case report.

In this study, a case of an ingested toothpick partially migrating from the sigmoid colon, causing massive lower gastrointestinal bleeding due to arterial-colic fistula, and stricture of the left ureter is presented. A 70-year-old male was admitted to the emergency department after having feces mixed with fresh and coagulated blood for the past two days. Computed tomography and retrograde ureteropyelography showed the stricture of the left ureter, 1.

Successful conservative and endoscopic treatment of pancreatic fistula due to splenectomy following blunt abdominal trauma.

Pancreatic fistula most commonly occur as a consequence of resective procedures and pseudocyst drainage, and rarely as a consequence of splenectomy. Conservative treatment can have good results, but it is long lasting and demands long hospitalization. In case of conservative treatment failure, operative treatment is indicated, but this has significantly higher percentage of morbidity and mortality.

Colonic lipoma intussusception: a case report.

Lipomas are the most common mesenchymal benign tumor of the colon. They are usually asymptomatic but may cause bleeding, obstruction, intussusception, or abdominal pain. The diagnosis can be made by colonoscopy, barium enema examination, and by computed tomography (CT).