Gastroenterology & Hepatology
Peer-reviewed articles on diseases of the digestive tract, liver and pancreas.
Articles from ASIDE Case Reports, ASIDE Gastroenterology, ASIDE Health Sciences, ASIDE Internal Medicine and ASIDE Oncology, newest first.
Articles
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Trends in Alcoholic Liver Disease and Nonalcoholic Fatty Liver Disease Underlying-Cause Mortality in the United States, 1999–2023
Background: Alcoholic liver disease (ALD) and nonalcoholic fatty liver disease (NAFLD) are major drivers of liver-related mortality in the United States, but comparative long-term trends remain unclear. Methods: We analyzed U.S. mortality data (1999–2023) from the CDC WONDER…
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Preparation for Gastrointestinal Endoscopy and Its Complications: A Narrative Review
Background: Gastrointestinal endoscopy is central to diagnosis and minimally invasive treatment but can cause bleeding, perforation, cardiopulmonary events, infection, and post-endoscopic retrograde cholangiopancreatography pancreatitis. Methods: This narrative review searched…
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Artificial Intelligence-Assisted EUS for Risk Stratification of Pancreatic Cystic Lesions: A Narrative Review of Current Evidence and Future Directions for Predicting High-Grade Dysplasia, Invasive Cancer, and the Need for Surgical Referral
Background: Pancreatic cystic lesions are increasingly detected on cross-sectional imaging, yet accurate risk stratification remains challenging. A clinically important minority, particularly intraductal papillary mucinous neoplasms and mucinous cystic neoplasms, may progress to…
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National Trends in Pancreatic Cancer-Related Mortality: A Population-Based Analysis of Rural–Urban Disparities and the Distribution of Place of Death
Background: Pancreatic Cancer is the sixth deadliest cancer across the world, and its incidence has more than doubled in recent decades. The literature lacks comprehensive evidence on rural-urban and place-of-death mortality trends over the last two decades. This retrospective…
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Artificial Intelligence in the Evaluation of Abnormal Liver Tests and MASLD: Emerging Applications in Risk Stratification and Clinical Decision Support
Background: Abnormal liver tests and metabolic dysfunction-associated steatotic liver disease (MASLD) are common, yet the central clinical task is identifying advanced fibrosis, cirrhosis, or an alternative liver disease that requires timely investigation or referral. Methods…
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Association of Irritable Bowel Syndrome with Dementia: A GRADE-Assessed Systematic Review and Meta-Analysis
Background: Numerous gastrointestinal (GI) diseases have been linked to an increased risk of dementia. Irritable bowel syndrome (IBS) is a prevalent GI disorder; however, existing studies investigating its association with dementia have reported mixed findings, and no prior…
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Comparative Outcomes of Glucagon-Like Peptide-1 Receptor Agonists versus Sodium-Glucose Cotransporter-2 Inhibitors in Patients with Cirrhosis
Background: Cirrhosis and metabolic comorbidities frequently coexist. Both glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) have shown cardiometabolic and hepatic benefits, but their comparative effectiveness in…
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Temporal Trends and Disparities in Liver Cell Carcinoma and Hepatic Failure Mortality in the United States: A 24-Year Analysis from CDC WONDER, 1999-2023
Background: Liver cell carcinoma (LCC) and hepatic failure (HF) are significant contributors to liver-related mortality in the United States. This study assessed LCC- and HF-related mortality trends (1999–2023) using CDC WONDER data, stratified by demographics and geography…
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Racial and Ethnic Disparities Across the MASLD/MASH Care Continuum in the United States: A Narrative Review
Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) affects 25.6% of U.S. adults and is the fastest-growing indication for liver transplantation. The 2023 MASLD nomenclature change, 2024 FDA approval of resmetirom, and 2025 accelerated approval of…
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Inter-Hospital Transfer and Outcomes in Acute Cholangitis: A National Inpatient Analysis
Background: Inter-hospital transfer is frequently used to facilitate access to advanced biliary intervention and higher-level care for patients with acute cholangitis. However, its association with inpatient outcomes remains incompletely defined. We evaluated the relationship…
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Early Palliative Care in Gastrointestinal Oncology: Evidence, Implementation Models, and Ethical Considerations
Background: Early palliative care is increasingly recognized as an important component of high-quality cancer care; however, the timing and extent of its integration vary across oncologic disciplines, including gastrointestinal (GI) oncology. Patients with GI malignancies…
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Endoscopic Vacuum Therapy Versus Self-Expanding Metal Stents for Upper Gastrointestinal Transmural Defects: A Narrative Review with Meta-Analytic Overlap Analysis, with Focus on Esophageal Anastomotic Leak and Perforation
Background: Upper gastrointestinal transmural defects carry mortality rates exceeding 20%. Endoscopic vacuum therapy (EVT) has emerged as a promising alternative to self-expanding metal stents (SEMS), yet optimal patient selection, timing, and technique remain uncertain…
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Endoscopy Timing in Older Adults (≥75 Years) with Upper Gastrointestinal Bleeding Undergoing Esophagogastroduodenoscopy: A Retrospective Cohort Study
Background: International guidelines recommend endoscopy within 24 hours for upper gastrointestinal bleeding (UGIB), yet real-world timing patterns in older adults remain uncertain. Methods: We conducted a retrospective single-center cohort study of 108 adults aged ≥75 years…
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Incidental Bilateral Pulmonary Emboli and Reactive Lymphadenopathy Secondary to Pancreatic Duct Leak in a Patient with Pancreatic Pseudocyst: A Case Report
Pulmonary embolism (PE) is a rare complication of acute pancreatitis (AP). We report a 40-year-old male who presented with a left breast lump and was found to have mild hyperprolactinemia and elevated pancreatic enzymes. Initial workup with abdominopelvic CT scan revealed…
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Biopsy-Detected Microscopic Colitis and Nonspecific Chronic Inflammatory Change in Patients with Chronic Diarrhea and Normal Colonoscopy: A Two-Case Series
Chronic diarrhea may occasionally persist despite macroscopically normal colonoscopy, and in selected patients, random colonic biopsy may reveal histologic abnormalities not apparent endoscopically. We report two illustrative cases of biopsy-detected microscopic or nonspecific…
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Proximal Duodenal Obstruction After Adult Ladd Procedure Diagnosed by Endoscopy: A Case Report
Intestinal malrotation is a congenital anomaly commonly occurring in infancy, with adult presentation being rare. The Ladd procedure is the standard treatment for symptomatic malrotation; however, postoperative complications in adults, including obstruction of the second portion…
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Primary Epstein-Barr Virus Infection Causing Severe Acute Hepatocellular Liver Injury With Evolving Cholestatic Features in a Young Adult: A Case Report and Contextual Review of Published Adult Cases
Primary Epstein-Barr virus (EBV) infection usually causes mild aminotransferase elevation. Severe jaundiced hepatitis without encephalopathy is uncommon in adults. We describe a 20-year-old woman with primary EBV-associated acute liver injury and summarize a March 2026…
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Pseudogallbladder Appearance on Ultrasonography After Cholecystectomy and Left Hemihepatectomy: A Postoperative Biliary Imaging Pitfall Clarified by MRCP
Accurate identification of postoperative biliary anatomy following hepatobiliary surgery can be challenging because normal anatomical landmarks are altered. A 75-year-old woman who had undergone cholecystectomy and left hemihepatectomy four months earlier for intrahepatic bile…
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Late-Onset Mesh Migration Following Hernia Repair: Two Cases of Enteric Fistulization
Mesh migration is a rare but serious late complication of hernia repair, often presenting years or even decades after implantation. Its clinical manifestations are nonspecific, making diagnosis challenging and frequently delayed until advanced complications occur. We report two…
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Long-Term Shifts and Disparities in Colorectal Cancer Mortality in the United States: A Population-Based Analysis (1999–2023)
Background: Colorectal cancer (CRC) remains a leading cause of cancer-related mortality in the United States despite advances in screening and treatment. Prior national studies have documented long-term declines in CRC mortality; however, emerging demographic and disparities…
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Selective Attenuation of Acetaminophen-induced Hepatobiliary Dysfunction by Pseudoelephantopus spicatus in Sprague-Dawley Rats
Background: Pseudoelephantopus spicatus (PS) is used in ethnomedicine for hepatic disorders; however, its effects on biochemical markers of drug-induced liver injury remain incompletely characterized. This study evaluated the effects of the ethanolic root extract of PS on serum…
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Overlapping Hyperemesis Gravidarum, Gestational Thyrotoxicosis, and Transaminitis in Early Pregnancy: A Case Report
Hyperemesis Gravidarum (HG), characterized by excessive emesis, fluid depletion, electrolyte imbalance, and weight loss, is a condition that affects approximately 0.3-2% of pregnancies. In this case report, we highlight the importance of careful investigation, evaluation, and…
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The Relationship Between pks⁺ Escherichia coli and Colorectal Cancer: A Review
Introduction: According to GLOBOCAN estimates, colorectal cancer (CRC) was the third most common cancer worldwide in 2020, comprising 11% of all cancer diagnoses. Researchers’ interest in CRC development has shifted toward the gastrointestinal microbiome, especially the…
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The Liver-Heart Axis: A Narrative Review of Clinical Implications of the MASLD Redefinition for Internists
Introduction: Metabolically-dysfunction-associated steatotic liver disease (MASLD) represents a paradigm shift emphasizing the metabolic underpinnings of hepatic steatosis and its systemic consequences. MASLD carries a substantial cardiovascular burden. This review examines the…
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Late Gastrointestinal and Genitourinary Progression of Metastatic Invasive Lobular Breast Carcinoma: A Case Report
Gastrointestinal (GI) and genitourinary (GU) metastases from breast cancer are uncommon and are most frequently associated with invasive lobular carcinoma (ILC). These metastases may occur many years after initial diagnosis and can closely mimic primary colorectal or urothelial…
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Boerhaave Syndrome in an Elderly Woman: A Case Report
Boerhaave syndrome is a rare emergency characterized by spontaneous esophageal perforation secondary to severe vomiting. Diagnosis is often difficult due to the nonspecific nature of the symptoms and their similarity to other emergencies. Mortality is high, and it increases if…
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Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Multisystemic Narrative Review of Cardiovascular and Oncological Implications
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) has surpassed viral hepatitis as the primary driver of chronic liver disease globally. While traditionally viewed through the lens of hepatic progression, its clinical trajectory is increasingly defined…
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Internal Herniation Beneath an Omphalomesenteric Band Arising from Meckel’s Diverticulum: A Rare Case Report of Small Bowel Obstruction in A Six-Year-Old Child
Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract and is usually asymptomatic, making preoperative diagnosis difficult in children. We report a 6-year-old boy with a 4-5-day history of progressively worsening periumbilical abdominal pain…
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Fish-Bone Migration to the Liver Causing Hepatic Abscess: A Scoping Review of Published Cases (2015–2025)
Background: Foreign body ingestion is common; however, migration of an ingested fish bone into the liver with subsequent abscess formation is rare, frequently presents with nonspecific abdominal symptoms, and poses a diagnostic challenge in routine clinical practice, often…
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ERCP Timing in Gallstone Disease: A Meta-Analysis of One-Stage versus Two-Stage Strategies
Background: Cholecystocholedocholithiasis involves gallbladder and bile duct stones. Standard two-stage care involves ERCP followed by cholecystectomy, whereas single-stage intraoperative ERCP may streamline treatment. We performed a meta-analysis comparing stone clearance…
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Endoscopic Sphincterotomy Increases the Risk of Pyogenic Liver Abscess: A Retrospective Study Using Real-World Data
Introduction: Pyogenic liver abscess (PLA) after Endoscopic Retrograde Cholangiopancreatography (ERCP) is a rare infectious adverse event. The association between post-ERCP PLA and endoscopic sphincterotomy has not been extensively studied. Methods: We conducted a retrospective…
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Demographic Factors of Colorectal Cancer (CRC) Patients with Paralytic Ileus Among Adults in the United States: A Retrospective Study for Mortality Trends
Background: Paralytic ileus is a serious postoperative complication among individuals with colorectal cancer (CRC). Although mortality trends for CRC and paralytic ileus have been described separately, long-term national patterns involving both conditions have not been examined…
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The Impact of Vonoprazan on Tacrolimus Blood Levels in Transplant Recipients: A Systematic Review and Meta-Analysis
Background: Tacrolimus is essential for immunosuppression in transplant recipients but presents risks of toxicity and rejection due to its narrow therapeutic window. Vonoprazan, increasingly replacing proton pump inhibitors (PPIs) in these patients, may alter tacrolimus blood…
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Emphysematous Gastritis in a Patient with Concomitant COVID-19 Infection and Celiac Trunk Stenosis: A Case Report
This case report reviews a 75-year-old male with several comorbidities who presented with acute encephalopathy and sepsis in the setting of COVID-19 pneumonia, who was noted to have significant gaseous distention of the stomach, emphysematous gastritis (EG), and severe stenosis…
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Malrotation with Midgut Volvulus Beyond Infancy Requiring an Extensive Ileal Resection: A Case Report
Midgut malrotation is a congenital anomaly resulting from abnormal rotation and fixation of the midgut during embryogenesis. It can be complicated by volvulus and intestinal obstruction. It rarely presents after the first year of life, which makes it a diagnostic challenge. A…
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Near-miss Osteomyelitis in an Immunosuppressed Crohn’s Disease Patient: Diagnostic Vigilance Sparked by a Medical Student
Crohn's disease (CD) patients on immunosuppressive therapy are at increased risk of infections, including osteomyelitis, which could be diagnostically challenging. This case highlights the importance of medical student vigilance in making a near-miss diagnosis of osteomyelitis…
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Comparative Outcomes of Esophageal Stent Placement in Esophageal Cancer Patients: A Prospective Study of 183 Cases
Introduction: Esophageal stent placement is a vital, minimally invasive procedure for alleviating dysphagia and enabling smoother food passage. It offers immediate relief, reduces hospital stays, and enhances quality of life for high-risk patients. Effective for both malignant…
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Gastrointestinal Non-Hodgkin Lymphoma: A Multifaceted Malady
Lymphomas account for approximately 5% of human malignancies and are classified as Hodgkin or non-Hodgkin variants. Non-Hodgkin lymphomas (NHL) constitute nearly 90% of all lymphomas, with diffuse large B-cell lymphoma (DLBCL) being the most prevalent histological subtype…
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Portal Venous Gas Following Laparoscopic Rectal Surgery: A Case Report of Internal Herniation without Bowel Necrosis
The presence of free air (pneumatosis) in the main and intrahepatic portal veins generally indicates acute mesenteric ischaemia, often accompanied by bowel necrosis. Internal herniation (IH) is a rare but serious complication of laparoscopic rectal surgery, where the mesenteric…
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Esophageal Stenting and Endoscopic Vacuum Therapy for Esophageal Defects: A Systematic Review and Meta-Analysis
Background: Spontaneous esophageal perforation, particularly Boerhaave syndrome, is a life-threatening condition associated with high morbidity and mortality. Traditional surgical management is increasingly being supplemented by minimally invasive approaches, including…
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Annular pancreas in adults presenting as chronic pancreatitis and duodenal obstruction: A review of literature and a rare case report
Background: Annular pancreas is a rare congenital anomaly with an estimated incidence of 3.4 per 1,00,000 live births. It is more commonly diagnosed in infants. Its occurrence in adults is exceptionally rare but clinically significant, as seen in our case, where it presented as…
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A Systematic Review and Meta-Analysis of Liver Transplant Outcomes in Lean Versus Non-Lean Metabolic Dysfunction-Associated Steatotic Liver Disease Patients
Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent hepatic disease with metabolic dysfunction-associated steatohepatitis (MASH) as its severe necro-inflammatory subtype. At present, it is the second leading cause of liver transplant. A…
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Evaluating Biliary Complications in Jaundiced Patients with Alcohol-Related Hepatitis: A Retrospective Study
Introduction: This study aims to differentiate whether jaundice in patients with alcoholic hepatitis (AH) is due to alcohol-related liver disease or underlying biliary pathology, including choledocholithiasis, primary sclerosing cholangitis, primary biliary cholangitis, benign…
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An Unusual Case of Disseminated Hydatid Disease: A Laparoscopic Wonder
Human echinococcosis, caused by Echinococcus tapeworms, is a zoonotic disease in which ingested eggs of the tapeworm form cysts in the organs known as Hydatid cysts. These cysts are commonly found in the Liver and lungs, but in rare cases, they can also be found in the spleen…
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Alternative Gastrointestinal Conditions Identified in Patients Meeting Rome IV Criteria for Irritable Bowel Syndrome or Functional Diarrhea Referred to Secondary Care: A Prospective Study
Introduction: Organic gastrointestinal (GI) disorders can be missed in individuals with irritable bowel syndrome (IBS). This study investigated the frequency of organic disorders in patients with diarrhea-predominant IBS or functional diarrhea and the impact of treatment for any…
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Efficacy and Safety of Tislelizumab in Combination with Chemotherapy versus Placebo Plus Chemotherapy in Patients with Advanced Gastric Cancer or Gastroesophageal Junction Cancer: A Systematic Review of Randomized Controlled Trials
Introduction: Advanced gastric cancer or gastroesophageal junction cancer (GC/GEJC) is an aggressive malignancy often having a poor prognosis. Despite current systemic therapies, GC/GEJC remains the third most common cause of cancer-related deaths worldwide. Tislelizumab, an…
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Probiotics: A Promising Ally in Burn Treatment
This review explores the potential therapeutic benefits of probiotics in the treatment of burn injuries, with the aim of addressing the limitations of traditional therapeutic approaches. It offers a comprehensive analysis of burn pathophysiology, including a wide range of burn…
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Pancreatic Rest Complicated by Actinomyces Gastric Abscess in a Young Male: A Case Report
Pancreatic rest, or ectopic pancreatic tissue, is a rare condition. It is characterized by pancreatic tissue outside its usual location, most commonly in the gastric antrum or proximal small intestine. We present a rare case of a 21-year-old male with recurrent epigastric pain…
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Challenges and Infectious Complications in Living Donor Liver Transplantation in Egypt: A Comprehensive Review
Background: Living donor liver transplantation (LDLT) is a crucial therapeutic option for patients with end-stage liver disease in Egypt, where deceased donor grafts are scarce. This study aims to investigate the challenges and infectious complications associated with LDLT in…
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Safety and Efficacy of Sodium Alginate and Mesna in Endoscopic Submucosal Dissection: A Systematic Review and Meta-analysis
Background: Sodium hyaluronate, commonly used in ESD, has drawbacks such as high cost and potential tumorigenesis. Sodium alginate (Na alginate) and Mesna offer promising alternative solutions with their viscoelastic and mucolytic properties. In this review we aimed to evaluate…
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Efficacy and Safety of Tofacitinib in Pediatric Ulcerative Colitis Patients: A Systematic Review
Introduction: Ulcerative colitis (UC), an inflammatory Bowel Disease (IBD), is a chronic illness of unknown mechanism affecting the colonic mucosa, mainly causing diarrhea and bleeding. It can potentially disrupt the quality of life. Tofacitinib, a Janus Kinase inhibitor, showed…
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Mycophenolate Mofetil Use for Inflammatory Bowel Disease
Mycophenolate Mofetil (MMF) is a prodrug that gets converted to mycophenolic acid (MPA). MPA inhibits the Akt/mTOR and STAT5 pathways and has a reversible cytostatic effect on T and B lymphocytes [1]. MMF is FDA-approved for immunosuppressive therapy after solid organ…
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Insights into the Epidemiology and Determinants of Helicobacter Pylori Negative Gastritis: A Retrospective Study
Introduction: The prevalence of Helicobacter pylori (HP)-negative gastritis is rising in the United States, yet its origins and risk factors remain largely unexplored. This study aims to assess the prevalence of HP-negative gastritis and explore the demographic, clinical, and…
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Mycophenolate Mofetil for the Treatment of Resistant Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
Background: This systematic review evaluates the efficacy and safety of Mycophenolate Mofetil (MMF) for managing treatment‐resistant Inflammatory Bowel Disease (IBD), emphasizing remission rates and adverse effects. Methods: Observational and controlled trials assessing MMF’s…
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Dexmedetomidine as an Adjunctive Sedative in Patients Undergoing Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis
Introduction: Endoscopic submucosal dissection (ESD) is a technique for removing dysplastic lesions in the gastrointestinal tract, but it carries risks like pain and perforation. Dexmedetomidine, an α2-receptor agonist, offers potential benefits as an adjunct sedative during ESD…
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Volvulus of Left Descending Colon: A Case Report and Systematic Review
Colonic volvulus has been described as the third most common cause of intestinal obstruction worldwide, with sigmoid volvulus representing more than 70% of all colonic volvulus. The descending colon is an atypical location for volvulus, with only a few documented cases in the…
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Prevalence of Metabolic-Associated Steatotic Liver Disease in Patients with Type 2 Diabetes with and without HIV: Retrospective Multicenter Study
Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a frequent complication in patients with Type 2 Diabetes (T2D). This study aims to evaluate the impact of HIV status on the prevalence of MASLD in patients with T2D. Methods: We utilized the…
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Potential Use of Icosapent Ethyl in the Management of Acute Pancreatitis
Dear Editor, We are writing to highlight the potential use of Icosapent Ethyl (Vascepa) as a management option for acute pancreatitis. To the best of my knowledge, a limited number of studies have investigated this use, but it is not yet Food and Drug Administration (FDA)…
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Usage of Trapezoid RX Wire Guided Retrieval Basket with the Alliance™ II Inflation Handle for Treatment of Bouveret Syndrome: A Rare Clinical Entity
Bouveret Syndrome is an infrequent manifestation of gallstone disease, causing gastric outlet obstruction. This syndrome has diagnostic and therapeutic challenges due to its rarity and non-specific clinical presentation. Here, we present a case report involving a 78-year-old…
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Real-World Epidemiological Analysis of Gastrointestinal Neuroendocrine Carcinomas: A TriNetX-Based Study
Introduction: Gastrointestinal neuroendocrine carcinomas (GI-NECs) are a diverse group of aggressive tumors with variable clinical outcomes. Although progress has been made in classifying and treating these cancers, detailed real-world data on their anatomical distribution and…
