Endoscopic or Conservative Management of Iatrogenic Duodenal Perforations Caused by Long Plastic Biliary Stent Distal Migration.

Plastic biliary stents are associated with rare but potentially life-threatening distal stent migration. We present 4 patient cases with distal migration, whereas the proximal aspect remained in the bile duct. Time to stent migration ranged from 1 week to 2 months.

Helicobacter pylori is Associated with Less Fistulizing, Stricturing, and Active Colitis in Crohn's Disease Patients.

Introduction A potential protective role of (HP) infection against the development of Crohn's disease (CD) has been postulated. There is a lack of studies evaluating the association of HP with CD phenotypes. The aim of this study was to investigate the clinical features and disease activity of patients with CD who were diagnosed with HP infection.

Acute Stroke After Upper Endoscopy in a Patient With a Suspected Atrioesophageal Fistula.

Atrioesophageal fistula (AEF) is a rare complication of atrial fibrillation ablation. We present a man with sepsis and frank hematemesis 3 weeks after atrial fibrillation ablation. Thoracic computed tomography showed no definitive evidence of AEF.

Barriers to treatment of chronic hepatitis C with direct acting antivirals in an urban clinic.

Introduction And Aim: Direct-acting antiviral (DAA) agents are highly effective for treatment of chronic hepatitis C virus (HCV) yet access to treatment remains a serious challenge. The aim of this study was to identify barriers to treatment initiation with DAA-containing regimens in an urban clinic setting.

Materials And Methods: A retrospective cohort of all chronic HCV patients seen in an urban academic practice in Jacksonville, FL, USA from 1/2014 to 1/2017 was analyzed.

Comparison of EUS-guided versus percutaneous and transjugular approaches for the performance of liver biopsies.

Background: Liver biopsy through endoscopic ultrasound (EUS) has become a novel approach for tissue acquisition. We aim to evaluate the adequacy of EUS-guided liver biopsies in comparison to those obtained through interventional radiology (IR) techniques.

Methods: A retrospective single-center analysis was performed of all IR (transjugular or image-guided percutaneous) and EUS-guided liver biopsies performed at an academic medical center from January 2016 to January 2018.

Ipilimumab and Nivolumab induced steroid-refractory colitis treated with infliximab: A case report.

Background: A variety of immune-modulating drugs are becoming increasingly used for various cancers. Despite increasing indications and improved efficacy, they are often associated with a wide variety of immune mediated adverse events including colitis that may be refractory to conventional therapy. Although these drugs are being more commonly used by Hematologists and Oncologists, there are still many gastroenterologists who are not familiar with the incidence and natural history of gastrointestinal immune-mediated side effects, as well as the role of infliximab in the management of this condition.

Botulinum Toxin as a Treatment for Refractory Gastroparesis: a Literature Review.

Purpose Of Review: Gastroparesis (GP) is a disorder of gastrointestinal motility which leads to delayed gastric emptying in the absence of mechanical obstruction. Treatment is limited as many patients are refractory to dietary modification and the use prokinetic medications carry significant adverse risks. These limitations necessitate more research into experimental therapies.

Intestinal Spirochetosis: An Obscure Cause of Lower Gastrointestinal Bleeding.

Adherence of spirochetes to the apical membrane of the colonic epithelium has been well-described in the literature, but the exact pathogenesis leading to symptomatic clinical manifestations is poorly understood. Most cases are found incidentally on the pathological evaluation of colonic biopsies taken during diagnostic or therapeutic colonoscopies. However, whether the colonization of the intestinal mucosa can be attributed to clinical symptoms is a matter of debate.

A longitudinal analysis of the epidemiology and economic impact of inpatient admissions for chronic pancreatitis in the United States.

Background: Chronic pancreatitis (CP) is a chronic, debilitating disorder associated with multiple complications, frequently necessitating hospitalization. The aim of this study was to investigate the longitudinal trends for hospitalization, mean length of stay (LOS), and cost associated with inpatient admissions for CP across the United States.

Methods: Using the Nationwide Inpatient Sample, all hospitalizations between 1997 and 2014 were analyzed.

Medical management of esophageal food impaction refractory to endoscopic interventions.

Most esophageal food impactions either pass spontaneously or are treated endoscopically. Severe food impactions can require extensive endoscopic therapy that potentially could lead to procedure-related complications. There are few alternate therapies available when endoscopy fails.

Patients' perceptions of gastroenterologists' attire in the clinic and endoscopy suite.

Background: Studying the role of gastroenterologists' attire can provide insight into patients' perceptions and help us optimize the physician-patient relationship. In this study we assessed patients' preference concerning gastroenterologists' attire, and its influence on patients' trust, empathy and perceptions of the quality of care in the clinic and endoscopic suite.

Methods: A cross-sectional survey was conducted from August 2016 to February 2017.

Predictors of No-show Rate in the GI Endoscopy Suite at a Safety Net Academic Medical Center.

Background/objectives: Noncompliance with physician and procedure appointments is associated with poor disease control and worse disease outcomes. This also impacts the quality of care, decreases efficiency, and affects revenue. Studies have shown that no-show rates are higher in clinics caring for underserved populations and may contribute to poorer health outcomes in this group.

Case Series of 10 Patients with Cirrhosis Undergoing Emergent Repair of Ruptured Umbilical Hernias: Natural History and Predictors of Outcomes.

Objectives: Ascites represents an important event in the natural history of cirrhosis, portending increased 1-year mortality. Umbilical herniation with rupture is an uncommon complication of large-volume ascites that is associated with significant morbidity and mortality. The aim of this study was to describe predictors of outcomes in patients undergoing emergent repair for spontaneous umbilical hernia rupture.

Randomized pragmatic trial of nasogastric tube placement in patients with upper gastrointestinal tract bleeding.

Unlabelled: The value of nasogastric (NG) tube placement in patients with upper gastrointestinal tract bleeding (UGIB) is unclear. We therefore aimed to determine the usefulness of NG tube placement in patients with UGIB. The study was a single-blind, randomized, prospective, non-inferiority study comparing NG placement (with aspiration and lavage) to no NG placement (control).

Clinical judgment does not circumvent the need for diagnostic endoscopy in upper gastrointestinal hemorrhage.

Background: To better understand the ability of physicians to predict the need for endoscopic therapy and to accurately predict specific endoscopic lesions, we performed a prospective, nonrandomized, observational cohort study in patients presenting with upper gastrointestinal hemorrhage (UGIH) who were undergoing endoscopy.

Aim: We aimed to evaluate the pre-endoscopy diagnostic accuracy and the correct prediction of high-risk lesions in patients with UGIH according to the level of clinical expertise.

Methods: One hundred twenty-one patients presenting with hematemesis and/or melena within 48 hours were studied.

The role of capsule endoscopy in evaluating inflammatory bowel disease.

Capsule endoscopy is a relatively new technology available in the investigation of IBD. Its place in the algorithm of evaluating IBD is being refined. Capsule endoscopy has the ability to visualize the entire SB with very few complications.

Interobserver agreement on the endosonographic features of lymph nodes in aerodigestive malignancies.

Background: Endoscopic ultrasound (EUS) is used to locally stage aerodigestive malignancies. Endosonographic features are used to predict malignant lymph nodes (MLN). Interobserver agreement on the endosonographic features of MLN has not been described.

Endoscopic mucosal resection with the grasp-and-snare technique through a double-channel endoscope in humans.

Background: EMR is being used to manage premalignant lesions of the GI tract. Lifting of the lesion is required to perform EMR. Earlier biopsy or snare may cause scarring and preclude adequate lifting.

Endoscopic colorectal imaging and therapy.

Purpose Of Review: Colorectal cancer screening and prevention is a pivotal element in every gastroenterologist practice. Recent advances in imaging technology and treatment opened the field for endoscopic management of large flat colorectal polyps and early cancer.

Recent Findings: High-definition white light colonoscopy allowed for better characterization of colon polyps, particularly flat lesions.