Disseminated Gastrointestinal Polyposis on Multidetector CT Enteroclysis

A 35-year-old male presented with chronic digestive complaints referred to our department for contrast CT enteroclysis study of the abdomen. Multidetector CT enteroclysisstudy was done after nasojejunal intubation and administration of oral (neutral)intravenous contrast. 

The study reveals multifocal, irregular, enhancing soft tissue lesion along peritoneal surface wilt associated scalloping of liver margin and ascites. There were multiple enhancing nodular intraluminal polyps starting from pylorus of stomach. There were also nodular enhancing deposits on omental surface. Irregularly marinated, enhancing nodular lesion was seen over omental surface, invading anterior abdominal wall muscle layer. Ileo-colic intussusception was seen with enhancing soft tissue along intussuscepted segment of bowel. It was long segment intussusception with polyp at lead paint of intussusception. Jejunum and ileal segment of bowel were diffusely showing multiple variable sized polyps. Soft tissue deposits were also seen in retroperitoneum.  Read more>>>>>>>>>>>>

 

Rationale for Using Social Media to Collect Patient-Reported Outcomes in Patients with Celiac Disease

In this age of social media woven into the fabric of our technologydriven world, today’s physicians are re-examining established ideals of patient privacy and professionalism. 

 While the rise of social media within patient care raises real concerns, web-based applications – such as Facebook, Twitter, Google+, Doximity, web blogs, instant messaging platforms, and video chat – represent a growing medium for patients to interact with other patients and social media-savvy health care providers. In gastroenterology, the online celiac disease (CD) community is the largest and most established network of patients exchanging ideas and experiences. Read more>>>>>>>>>>>>>>>

Educational Needs of Patients with Inflammatory Bowel Disease (IBD) and Non- Adherence to Medical Therapy-A Qualitative Study

IBD can be debilitating to those afflicted, and adverse effects from medical and/or surgical therapy may further contribute to a reduction in quality of life. 

Poorly controlled disease increases the risk for serious and often irreversible negative outcomes including death. Patient non-adherence to medical therapy may contribute to sub optimal disease control and complications. Non-adherence to medical therapy may be associated with demographic factors such as gender (male) and marital status (single) . Individuals may forego medical and/or surgical therapy due to inconvenience, costs, lack of understanding, or fear of side effects from therapy. Read more>>>>>>>>>>>>>>

Spleen-Preserving Distal Pancreatectomy that also Preserves Splenic Vessels

Spleen-preserving distal pancreatectomy (SPDP) is steadily becoming more common as a means of performing limited resection of the pancreas. Spleen preserving procedure a limited resection as compared to the distal pancreatectomy and splenrctomy, which procedure is very usuallry done. 

This surgical procedure is considered significant because it may prevent postoperative infection and pneumonia, while also blocking platelet count elevation. Kimura et al. reported on “SPDP thatalso preserved splenic vessels,” deeming it as a safe and reliable surgical procedure. Since then, there have been several reports of cases in which this procedure was successfully performed. Surgical procedures that preserve blood flow to the pancreas include the Kimura method, which preserves splenic vessels, and the Warshaw method, which resects splenic vessels and preserves short gastric vessels. Read more>>>>>>>>>>>>>>

Abdominal Cocoon A Rare Complication of Abdominal Tuberculosis

Abdominal cocoon is not only a rare complication of abdominal tuberculosis but also a rare cause of intestinal obstruction. As this condition is characterised by thickening and fibrosis of peritoneum with subsequent wrapping of the variable length of small and sometimes, large bowel in a stack or concertina pattern, itis also known as peritonitis chronic fibrosa in capsulata or sclerosingencapsulating peritonitis. 

This condition is difficult to diagnose clinically but can be easily recognised by imaging. Early recognition allows early management and may prevent the need for operative intervention or bowel resection.

Discussion: The term abdominal cocoon was coined by Foo et al in 1978. Various etiologic factors including previous abdominal surgery, peritonitis, chronic ambulatory peritoneal dialysis, prolonged use of the ß-blockers like practolol/propranolol, ventriculoperitoneal shunts, granulomatous diseases like sarcoidosis and tuberculosis, autoimmune diseases like systemic lupus erythematosus, viral infections, etc. have been implicated. Geographically, the condition is predominantly seen in the tropical regions and mainly in young females. Read more>>>>>>>>>>>>>>>

Gastric Diverticulum: A Rare Endoscopic Finding

Gastric diverticulum is a rare condition with a prevalence of 0.02% in autopsiesstudies and 0.04% through imaging studies of the upper gastrointestinal tract, it is distribution is the same for both men and women, gastric diverticulum are classified into congenital and acquired types, of which, congenital types are more common.    

Congenital gastric diverticulum, located in the retroperitoneal space, may be explained by embryogenesis. Acquired gastric diverticulum’s are pseudo diverticula and are typically located in the gastric antrum. The most common age of presentation is between the fifth and sixth decades of life, however there are cases reported in children at 9 years-old. There is no pathognomonic clinical data to suspect this disease, patients usually present with dyspepsia, gastro-esophageal reflux disease even upper gastrointestinal bleeding, it represents a challenge for the physician. Read more>>>>>>>>>>>>>>

Sphincterotomy Related Perforations Diagnosed by CT: Incidence, Risk Factors and Outcome

Of all the gastrointestinal endoscopic interventional techniques, endoscopic retrograde cholangiopancreatography (ERCP) recorded the highest rate of complications with great variability. These include pancreatitis, bleeding, cholangitis and perforation. Despite its low incidence, ranging from 0.3% to 1.3%, duodenal perforation occurring during ERCP has been shown to cause high mortality of 16–18%. 

Several classifications of ERCP-related perforations have been published in the medical literature and management guidelines based on clinical and radiological criteria have been developed. However, the management of ERCP related perforations remains controversial: conservative versus early operative treatment. There is no doubt that early and accurate diagnosis of perforations cannot be underestimated. It has been proposed that delayed diagnosis may result in dire outcome. Abdominal computerized tomography (CT) is considered the best modality for the diagnosis of perforations. Read more>>>>>>>>>>>>>