جستجوی مقالات مرتبط با کلیدواژه « upper gastrointestinal tract » در نشریات گروه « پزشکی »

Gastrointestinal tract complaints are prevalent among individuals in rural settings, encompassing all age groups. This study aimed to examine histopathological lesions in the upper gastrointestinal tract through endoscopic biopsy and determine the frequency of various upper gastrointestinal lesions in relation to age, sex, and site.

The specimens included in our study comprise endoscopic biopsies of the upper gastrointestinal tract during October 2018 to October 2020. A total of 70 biopsies from the upper gastrointestinal tract were analyzed using endoscopy. All specimens were fixed in 10% formalin and processed following routine hematoxylin and eosin (HE) examination. Special stains were employed when necessary.

Among the 70 upper gastrointestinal endoscopic biopsies studied during this period, 25 (35.71%) were from the esophagus, 35 (50.0%) were from the stomach, and 10 (14.29%) were from the duodenum. Of the 70 upper gastrointestinal endoscopic biopsies, 34 displayed inflammatory lesions, while 36 exhibited neoplastic lesions. There was a male predominance among the cases examined. Non-neoplastic lesions were observed in individuals aged from the second to the fifth decade, while neoplastic lesions were more prevalent in older age groups.

This research highlights the stomach as the predominant location for inflammatory and neoplastic lesions in the upper gastrointestinal tract. The study reveals a notable occurrence of gastric carcinoma among malignant upper gastrointestinal lesions. Thus, early detection and management of upper gastrointestinal lesions necessitate endoscopy and subsequent histopathological evaluation.

The prevalence of eosinophilic esophagitis (EoE) has increased in recent decades. Recent studies have found that the prevalence of EoE in patients with celiac disease (CD) is much higher compared with the general population. In this study, the prevalence of EoE in children with CD was calculated and their clinical symptoms, endoscopic and histopathological findings were compared.
This was a retrospective study conducted on the data records of the patients diagnosed with celiac disease during 2012-2020, and registered at Imam Hossein Children’s Hospital and the Institute of the Celiac Association in Isfahan, Iran. Clinical findings, endoscopic reports, serological and histopathological data of the patients were recorded and analyzed.
A total of 80 children with CD were included in the study. The mean age of the patients with CD and EoE (n=8) was 7.75± 3.99 years, and in children with CD alone (n=72), the mean age was 7.85± 3.83. The most common clinical findings were abdominal pain, anorexia, diarrhea and constipation. There were no significant differences in the symptoms of either group. The most common endoscopic view was duodenal scalloping and esophagitis; and 50% of EoE patients had a normal endoscopic view of the esophagus. With regards to serological findings, the level of TTG-IgA (U/ml) in the CD and EoE group was higher than the CD group (183.73 ± 101.54 vs. 117.07 ± 95.34 U/ml); however, no statistically significant difference was observed.
Our study found that the prevalence of EoE in children with CD appears to be higher than in previous studies.  We have also shown that the presence of EoE cannot be detected solely based on clinical and even endoscopic results.  Therefore, an esophageal biopsy is recommended in celiac patients.

The standard method for reconstruction after total gastrectomy is Roux-en-Y reconstruction, which has several negative points such as malabsorption. The most important reasons for weight loss in these patients are reserval insufficiency and reduction of food-digestive juice blending. We suggest that the creation of a food reserve with a natural conduit by ileocolic interposition may help the patient to have more normal diet habits and prevent severe weight loss.

The study enrolled 8 patients with proximal gastric cancer, who underwent total gastrectomy with omentectomy and D2 lymphadenectomy. Then, the ileocolic segment with its vasculature was prepared and the anastomosis was done like right colon interposition between esophagus and duodenum. Intraoperative and postoperative events and also nutritional conditions were recorded.

Among 8 patients enrolled in the study, not an intraoperative bad event nor anastomotic site leakage, abscess formation, or other significant post-operative complication were seen. Except for the first two patients, the rest did not suffer from dysphagia. None of the patients suffered from delayed, chronic, or uncontrolled vomiting. All patients experienced weight loss postoperatively but after 2 months, they gained weight. Barium examination and also upper endoscopy revealed that the patients had normal reserval volume, no evidence of erosion or ulceration, no evidence of biliary esophagitis or reflux, and absence of tumor relapse.

Because of the nutritional benefits of ileocolic interposition after total gastrectomy in gastric cancer treatment, it can be used as an acceptable alternative method of reconstruction in a subgroup of selected patients.

Prediction of the outcome and severity of acute upper gastrointestinal bleeding (UGIB) has significant importance in patient care, disposition, and determining the need for emergent endoscopy. Recent international recommendations endorse using scoring systems for management of non-variceal UGIB patients. To date, different scoring systems have been developed for predicting the risk of 30-day mortality and re-bleeding. We have discussed the screening performance characteristics of Baylor bleeding score, the Rockall risk scoring score, Cedars-Sinai Medical Center predictive index, Glasgow Blatchford score, T-score, and AIMS65 systems, in the present review. Based on the results of this survey, there are only 3 clinical decision rules that can predict the outcome of UGIB patients, independent from endoscopy. Among these, only Glasgow Blatchford score was highly sensitive for predicting the risk of 30-day mortality and re-bleeding, simultaneously.