Journal of clinical gastroenterology
-
J. Clin. Gastroenterol. · Jul 2003
Risk of colorectal adenoma in liver transplant recipients compared to immunocompetent control population undergoing routine screening colonoscopy.
Immunosuppression following solid organ transplantation has been associated with a higher prevalence of cancers including colon cancer. However, the risk of colorectal adenoma following liver transplantation is unknown. The objective of this pilot study is to determine whether the prevalence of colorectal adenoma is increased in liver transplant recipients. ⋯ Liver transplant recipients appear to have an increased risk for developing colorectal adenoma. Early screening colonoscopy is warranted for this group of patients.
-
J. Clin. Gastroenterol. · Apr 2003
Comment Comparative StudyOutcomes of endoscopic treatment of gastroduodenal Dieulafoy's lesion with rubber band ligation and thermal/injection therapy.
Dieulafoy's lesion is a rare but important cause of upper gastrointestinal bleeding. Current endoscopic methods used to treat Dieulafoy's lesion include injection, with or without thermal methods, and mechanical methods. The latter include variceal ligation and hemoclips. There are no studies comparing the outcomes of rubber band ligation and injection with or without thermal therapy. ⋯ Endoscopic rubber band ligation is as effective as injection with or without thermal therapy in the treatment of Dieulafoy's lesion.
-
J. Clin. Gastroenterol. · Mar 2003
Comparative StudyBalthazar computed tomography severity index is superior to Ranson criteria and APACHE II and III scoring systems in predicting acute pancreatitis outcome.
Acute pancreatitis runs an unpredictable course. We prospectively analyzed the prognostic usefulness of four different scoring systems in separately assessing three variables; acute pancreatitis severity, development of organ failure and pancreatic necrosis. ⋯ In all outcome measures the APACHE scores generate small and of similar extent changes in probability. The Balthazar score is superior to other scoring systems in predicting acute pancreatitis severity and pancreatic necrosis. However the Ranson and APACHE scores perform slightly better with respect to organ failure prediction.
-
Hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu disease, is an hereditary disorder that results in fibrovascular dysplasia with the development of telangiectasias and arteriovenous malformations. It predominantly involves the skin, mucous membranes, viscera, lungs, and brain. Hereditary hemorrhagic telangiectasia shows great genetic heterogeneity, and its phenotypes have been classified based on the recently identified mutated genes: endoglin (HHT-1) and activin-like kinase receptor-1 (HHT-2). ⋯ Liver involvement is reported in up to 30% of persons affected by HHT. Large arteriovenous malformations in the liver can lead to significant complications, including high-output congestive heart failure, portal hypertension, hepatic encephalopathy, biliary ischemia, and liver failure. Embolization of large arteriovenous malformations in the liver remains controversial; however, liver transplantation can successfully eradicate these complications.
-
J. Clin. Gastroenterol. · Jan 2003
Temporal trends over ten years in formal inpatient gastroenterology consultations at an inner city hospital.
Inpatient consultation is an important, but poorly understood, component of medical subspecialty practices. In a time when all services strive for cost-effective and efficient treatments, little is known about the epidemiology of inpatient subspecialty consultation. This study is designed to describe the nature and trends of formal inpatient gastroenterology consultations during the past decade. ⋯ Formal inpatient gastroenterology consultations and inpatient gastrointestinal endoscopic procedures have significantly increased over the past 10 years, despite pressures to decrease costs of inpatient care. The main reason for formal inpatient gastroenterology consultations shifted from abnormal liver tests to gastrointestinal bleeding.