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J Surg Case Rep 2020 Jun 25;2020(6):rjaa124. Epub 2020 Jun 25.

Department of Surgery, JA Kohseiren Enshu Hospital, Hamamatsu, Japan.

An 81-year-old woman had undergone laparoscopic abdominoperineal resection for rectal cancer. A permanent colostomy was created through an intraperitoneal route. Three months after the surgery, the patient presented with lower abdominal pain and vomiting. Read More

J Investig Med 2020 Jul 2. Epub 2020 Jul 2.

Department of Obstetrics and Gynecology, Chifeng Municipal Hospital, Chifeng, China.

The objective of this study was to determine the role of miR-3150b-3p in the cervical cancer (CC) progression. Real-time PCR and western blot analysis were conducted to test the expression of miR-3150b-3p, TNFRSF11a and p38 mitogen-activated protein kinase (MAPK) signaling pathway. The interaction between miR-3150b-3p and TNFRSF11a was verified by luciferase assay. Read More

J Gastroenterol Hepatol 2020 Jun 29. Epub 2020 Jun 29.

Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Science, Bhubaneswar, India.

Gastrointest Endosc 2020 Jun 25. Epub 2020 Jun 25.

Division of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland. Electronic address:

Technological advancements in the field of therapeutic endoscopy have led to the development of minimally invasive techniques to create a gastrointestinal anastomosis without requiring surgery. Examples of the potential clinical applications of these novel endoscopic techniques can be bypassing malignant and benign gastric outlet obstruction, providing access to the pancreatobiliary tree in those who have undergone Roux-en-Y gastric bypass and to relieve pancreatobilliary symptoms in afferent loop syndrome. Endoscopic gastrointestinal anastomosis is less invasive and expensive than surgical approaches, which may be more appealing to patients and result in improved outcomes. Read More

Gastrointest Endosc 2020 Jul;92(1):225

First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

J Indian Assoc Pediatr Surg 2020 May-Jun;25(3):172-174. Epub 2020 Apr 11.

Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

Adenomyoma of the stomach is a benign tumor with a very low incidence. Clinical presentation and imaging modalities are usually nonspecific and variable. A rare case of gastric adenomyoma in a 12-year-old child is being reported who presented with gastric outlet obstruction. Read More

Zhonghua Zhong Liu Za Zhi 2020 Jun;42(6):445-448

Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

To explore the clinical value of totally laparoscopic stomach-partitioning gastrojejunostomy (TLSPGJ) for malignant gastric outlet obstruction. The clinical data of 9 gastric cancer patients who underwent TLSPGJ in Department of Pancreatic and Gastric Surgery, Cancer Hospital between September 2018 and September 2019 were retrospectively analyzed. The mean operative blood loss of 9 cases were (13. Read More

Gastrointest Endosc 2020 Jun 18. Epub 2020 Jun 18.

Division of Gastroenterology and Hepatology, University of Utah Hospital, 30 N 1900 E, 4R118, Salt Lake City , UT 84132.

Background And Aims: Self-expandable metal stents are used for palliation of malignant gastric outlet obstruction (GOO). Studies comparing covered self-expandable metallic stents (C-SEMSs) and uncovered self-expandable metallic stents (U-SEMSs) have led to inconclusive results. We compared efficacy and safety of C-SEMSs versus U-SEMSs in patients with GOO. Read More

J Surg Res 2020 Jun 16. Epub 2020 Jun 16.

Division of Pediatric Surgery, Department of Surgery, Rush University Medical Center, Chicago, Illinois; Rush Center For Clinical Skills and Simulation, Rush University Medical Center, Chicago, Illinois.

Background: Surgical simulation-based training (SBT) can increase resident confidence and improve performance. SBT in pediatric surgery is in its infancy and often geared toward training pediatric surgery fellows. Since case volume for various pediatric surgery-specific procedures can be low based on the rarity of the pathology involved and the level of care provided by the institution, our aim was to create a pediatric surgery simulation-based curriculum for general surgery residents to address this need. Read More

Turk J Pediatr 2020 ;62(3):501-504

Departments of Pediatric Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Background: Pyloroduodenal intussusception (PDI) due to gastric and pyloric polyps is very rare and has not been reported previously in children.

Case: A 3 year-old boy was admitted with non-bilious vomiting and abdominal distention. Abdominal X-ray showed gastric air-fluid level and ultrasonography showed 5 cm intussusception at right upper quadrant. Read More

Indian J Tuberc 2020 Apr 1;67(2):274-276. Epub 2020 Feb 1.

Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Science, Raibareli Road, Lucknow 226014, India.

Tuberculosis of the stomach is quite rare, both as a primary or secondary infection. It has varied presentation ranging from non-specific abdominal pain and constitutional symptoms to hematemesis, gastric outlet obstruction and pyrexia of unknown origin. Here, we report a rare, interesting case of locally advanced gastric tuberculosis, which morphologically mimicked liver abscess initially in a young, immunocompetent patient presenting with fever and abdominal pain. Read More

World J Gastroenterol 2020 Jun;26(21):2715-2728

Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.

The advent of lumen apposing metal stents (LAMS) has revolutionized the management of many complex gastroenterological conditions that previously required surgical or radiological interventions. These procedures have garnered popularity due to their minimally invasive nature, higher technical and clinical success rate and lower rate of adverse events. By virtue of their unique design, LAMS provide more efficient drainage, serve as conduit for endoscopic access, are associated with lower rates of leakage and are easy to be removed. Read More

World J Gastrointest Pharmacol Ther 2020 Jun;11(2):8-16

Division of Gastroenterology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan 48108, South Korea.

Gastric outlet obstruction (GOO) is a medical condition characterized by epigastric pain and postprandial vomiting due to mechanical obstruction. The obstructions typically involved in GOO can be benign or malignant. Peptic ulcer disease is the most common cause of benign GOO, and malignant causes include gastric cancer, lymphoma, and gastrointestinal stromal tumor. Read More

World J Clin Cases 2020 Jun;8(11):2116-2126

Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.

Achalasia is a type of esophageal motility disorder, consisting of relaxation dysfunction of the lower esophagus and disturbed esophageal peristalsis. Related clinical symptoms include dysphagia, regurgitation, chest pain, and weight loss. Traditional treatment options include endoscopic botulinum toxin injection, endoscopic pneumatic dilation, and laparoscopic Heller's myotomy. Read More

Expert Rev Anticancer Ther 2020 Jun 23:1-6. Epub 2020 Jun 23.

Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center , Houston, TX, USA.

Introduction: Proactive palliative care can effectively relieve symptoms early and effectively as well as improve the quality of life of patients with gastric adenocarcinoma (GAC).

Areas Covered: The review summarizes palliative care for GAC. GAC caused specific symptoms, such as malignant gastric outlet obstruction (GOO), bleeding, weight loss, and/or ascites, therefore, these symptoms must be addressed specifically. Read More

Ann R Coll Surg Engl 2020 Jun 15:e1-e4. Epub 2020 Jun 15.

Frimley Park Hospital, Frimley Health NHS Foundation Trust, Frimley, Camberley, UK.

Idiopathic retroperitoneal haematoma is a rare clinical entity; resulting duodenal obstruction is even more occult. It can pose a diagnostic challenge due to variable presentations. Timely management requires a high index of suspicion and a multidisciplinary approach. Read More

Ann R Coll Surg Engl 2020 Jun 15:1-4. Epub 2020 Jun 15.

Department of General Surgery, Inverclyde Royal Hospital, Greenock, Scotland, UK.

Introduction: Placement of a duodenal or pyloric stent is a recognised palliative procedure for symptomatic relief of malignant gastric outlet obstruction. This procedure can be associated with significant complications, reinterventions and poor long-term relief of obstructive symptoms. However, there may be a faster return to diet and shorter hospital stay in comparison to other palliative procedures (eg gastrojejunostomy). Read More

Endoscopy 2020 Jun 12. Epub 2020 Jun 12.

Amsterdam UMC, Gastroenterology & Hepatology, Amsterdam, Netherlands.

Background And Study Aims: The majority of patients with symptomatic sterile walled-off necrosis can be treated conservatively. Although endoscopic transluminal drainage is often performed in case of persistent symptoms, post-procedural iatrogenic infection may occur. The aim of this study was to evaluate the clinical outcome after endoscopic transluminal drainage of symptomatic sterile walled-off necrosis. Read More

World J Clin Cases 2020 May;8(10):1979-1987

Department of Gastroenterology, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, Guangdong Province, China.

Background: Heterotopic pancreas is a common lesion found in the gastrointestinal tract and is usually considered a benign disease. Reports of malignant change of heterotopic pancreas are scarce.

Case Summary: A 44-year-old Chinese female underwent a gastroscopy to assess abdominal distension that had persisted for 2 months. Read More

GE Port J Gastroenterol 2020 Apr 7;27(3):172-184. Epub 2019 Oct 7.

Gastroenterology Department, Instituto Português de Oncologia Francisco Gentil, Porto, Portugal.

Background: Digestive tumours are among the leading causes of morbidity and mortality. Many cancer patients cannot maintain oral feeding and develop malnutrition. The authors aim to: review the endoscopic, radiologic and surgical techniques for nutritional support in cancer patients; address the strategies for nutritional intervention according to the selected technique; and establish a decision-making algorithm to define the best approach in a specific tumour setting. Read More

Dig Liver Dis 2020 Jun 3. Epub 2020 Jun 3.

Gastro Unit, Division of Endoscopy, Copenhagen University Hospital Herlev, Denmark.

Background And Aims: Endoscopic ultrasound-guided gastro-enteric anastomosis (EUS-GEA) using lumen-apposing metal stents (LAMS) is emerging as a minimally invasive alternative to surgery across several indications. Literature on this subject is heterogeneous, with variable reporting of techniques and outcomes. Our aim was to perform a meta-analysis of published data on EUS-GEA, providing a pooled estimate of technical and clinical outcomes. Read More

Rev Esp Enferm Dig 2020 Jun 4;112. Epub 2020 Jun 4.

WIDER Barcelona. Digestive Endoscopy Unit, Hospital Universitari Vall d'Hebron.

Aim: to evaluate the safety and effectiveness of self-expandable metal stent placement for malignant gastric outlet obstruction (GOO).

Methods: a retrospective, analytic cohort study at a single, tertiary-care center.

Results: thirty-six patients that underwent stent placement for GOO of malignant origin were identified during the study period. Read More

Int J Surg Case Rep 2020 25;71:315-318. Epub 2020 May 25.

General Surgery Department, San Salvatore Hospital, Paternò, Catania, Italy.

Introduction: Bouveret's syndrome is a rare complication of cholelithiasis that determines an unusual type of gallstone ileus, secondary to an acquired fistula between the gallbladder and either the duodenum or stomach with impaction of a large gallbladder stone. Preoperative diagnosis is difficult because of its rarity and the absence of typical symptoms. Adequate treatment consists of endoscopic or surgical removal of obstructive stone. Read More

World J Emerg Surg 2020 Jun 1;15(1):37. Epub 2020 Jun 1.

Unit of General Surgery "V. Bonomo", Department of Biomedical Sciences and Human Oncology, University of Bari "A. Moro", Polyclinic of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy.

Background: Giant hiatal hernia (GHH) is a condition where one-third of the stomach migrates into the thorax. Nowadays, laparoscopic treatment gives excellent postoperative outcomes. Strangulated GHH is rare, and its emergent repair is associated with significant morbidity and mortality rates. Read More

Medicine (Baltimore) 2020 May;99(21):e19432

Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Self-expandable metallic stent (SEMS) placement is widely used for relieving symptoms in malignant gastric outlet obstruction (MGOO). This study aimed to evaluate the efficacy and safety of multiple gastroduodenal stent placement using the stent-in-stent technique and to identify factors predictive of stent patency.We retrospectively analyzed data from 170 patients with GOO receiving SEMS using the stent-in-stent technique between July 2006 and July 2018. Read More

World J Gastroenterol 2020 May;26(19):2458-2463

Department of Gastroenterology, Franciscus Gasthuis & Vlietland, Rotterdam 3045 PM, Zuid-Holland, Netherlands.

Background: Bouveret´s syndrome is defined as a gastric outlet obstruction after passage of a gallstone through a fistula into the duodenum. Due to its rarity, the diagnosis of Bouveret's syndrome is often delayed and causes a high morbidity and mortality rate.

Case Summary: A 93-year-old female presented with worsening pain in the right upper abdomen and vomiting. Read More

J Microbiol Immunol Infect 2020 May 18. Epub 2020 May 18.

Division of Infectious Disease, Department of Internal Medicine, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:

Pediatr Int 2020 May;62(5):654-655

Pediatric Department, Faculty of Medicine, Saint Vincent De Paul Hospital, Bar Ilan University, Nazareth, Israel.

Pediatr Radiol 2020 Jul 27;50(8):1102-1106. Epub 2020 May 27.

Department of Radiology and Imaging Sciences, Emory School of Medicine, Atlanta, GA, USA.

Background: Hypertrophic pyloric stenosis (HPS) is a common cause of gastric outlet obstruction in young infants. Infants with HPS present with projectile vomiting, sometimes have electrolyte abnormalities and typically undergo pyloromyotomy to alleviate the obstruction. Abdominal US is the gold standard imaging study for diagnosis. Read More

Clin Imaging 2020 Aug 13;64:103-118. Epub 2020 Mar 13.

University of Maryland Medical Center, Department of Diagnostic Radiology and Nuclear Medicine, 22 South Greene Street, Baltimore, MD 21201, United States.

Ultrasonography is an essential tool in pediatric imaging, particularly in the emergency setting. Although ultrasound is often the favored initial modality for abdominal imaging in children, it is highly operator-dependent and therefore prone to misinterpretation which can lead to false positive or negative exams, or even incorrect diagnoses. Conditions discussed in this series include ileocolic intussusception, hypertrophic pyloric stenosis, appendicitis, and ingested foreign bodies. Read More

Acta Med Port 2020 May 4;33(5):347-349. Epub 2020 May 4.

Serviço de Cirurgia Geral. Unidade Local de Saúde de Matosinhos. Matosinhos. Departamento de Cirurgia Geral. Faculdade de Medicina. Universidade do Porto. Porto. Portugal.

Bouveret's syndrome is a rare cause of gastric outlet obstruction. We report a case of a 68-year-old woman admitted with upper digestive obstruction. A few months later, and after several diagnostic tests and clinical surveillance, a cholecystoduodenal fistula was suspected. Read More

Int J Surg Case Rep 2020 8;70:64-67. Epub 2020 May 8.

Department of General Surgery, North Alentejo Local Unit E.P.E., Portugal.

Background: The prevalence of Peptic Ulcer Disease has decreased as did its elective surgical treatment, however its complications continue to occur. Gastric Outlet Obstruction is the least frequent complication of Peptic Ulcer disease.

Case Summary: In this report, we present a case of massive gastric dilation due to gastric outlet obstruction, that needed emergency surgery due to perforation. Read More

Gan To Kagaku Ryoho 2020 May;47(5):831-834

Digestive Disease Center, Showa University Northern Yokohama Hospital.

A 74-year-old man with upper abdominal pain and anorexia was referred to our hospital in December 2013. Based on computed tomography(CT)and gastroendoscopy findings, the patient was diagnosed as having advanced gastric cancer with multiple liver metastases(S3, S5, and S6 lesions). Because of high pyloric stenosis, distal gastrectomy Roux-en-Y reconstruction was performed in mid-December 2013. Read More

Med Sci Monit 2020 May 14;26:e921555. Epub 2020 May 14.

Department of Pediatric Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland).

BACKGROUND This study aimed to investigate the safety and effectiveness of laparoscopic pyloromyotomy for infants with congenital hypertrophic pyloric stenosis. MATERIAL AND METHODS The clinical data of 233 infants with congenital hypertrophic pyloric stenosis who were treated at our hospital from January 2013 to January 2018 were analyzed retrospectively. The patients were divided into 2 groups: the laparoscopic group (group A, n=126) and the conventional operation group (group B, n=107). Read More

World J Gastroenterol 2020 Apr;26(16):1847-1860

Digestive Endoscopy Unit, Humanitas Clinical and Research Center - IRCCS -, via Manzoni 56, 20089 Rozzano (Mi), Italy.

Malignant gastric outlet obstruction (MGOO) is a clinical condition characterized by the mechanical obstruction of the pylorus or the duodenum due to tumor compression/infiltration, with consequent reduction or impossibility of an adequate oral intake. MGOO is mainly secondary to advanced pancreatic or gastric cancers, and significantly impacts on patients' survival and quality of life. Patients suffering from this condition often present with intractable vomiting and severe malnutrition, which further compromise therapeutic chances. Read More

Am J Emerg Med 2020 Apr 29. Epub 2020 Apr 29.

Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC, United States of America. Electronic address:

We report the case of a 21-year-old female presenting with severe hypernatremia and a gastric outlet obstruction due to chronic purging behavior with salt water flushes. She presented obtunded following emesis and a witnessed seizure. She was found to have a corrected sodium level of 177 mmol/L. Read More

Gan To Kagaku Ryoho 2020 Mar;47(3):513-515

Dept. of Surgery, National Hospital Organization Osaka National Hospital.

A 62-year-old woman was diagnosed with gastric cancer, Type 4, cT4b(LN, mesentery of transverse colon), N1 M1H0P1CY1, cStage ⅣB. S-1 and L-OHP(SOX)were administered for 4 courses and clinical response was SD. She interrupted the treatment because of practicing folk therapy. Read More

Cureus 2020 Apr 4;12(4):e7542. Epub 2020 Apr 4.

Gastroenterology, University of Louisville, Louisville, USA.

A 57-year-old male with a history of gastroesophageal reflux disease and esophageal strictures presented with melena and abdominal pain. He underwent an esophagogastroduodenoscopy, which revealed a 5-cm duodenal bulb mass causing partial obstruction of the gastric outlet. Endoscopic ultrasound showed a 5-cm, hypoechoic lesion, arising from the mucosal layer, with a large blood vessel feeding the lesion. Read More

Sisli Etfal Hastan Tip Bul 2020 25;54(1):1-7. Epub 2020 Mar 25.

Department of General Surgery, Okan University, Faculty of Medicine, Istanbul, Turkey.

Gastric outlet obstruction that arises from gallstones impacted in the distal stomach or proximal duodenum after passing through a cholecystoduodenal, cholecystogastric or rarely choledocoduodenal fistula is called as Bouveret's syndrome and it accounts for approximately 1-3% of all the patients with gallstone ileus. Although treatment modalities, including stone removal or fragmentation with classical endoscopic devices, such as snares, and forceps or fragmentation of gallstones with new devices, such as electrohydraulic lithotripsy, laser, extracorporeal shockwave lithotripsy have been described. However, only 29% of the patients benefit from nonsurgical methods. Read More

Surg Endosc 2020 May 1. Epub 2020 May 1.

Department of Internal Medicine and Gastroenterology, Hospital Ludwigsburg, Ludwigsburg, Germany.

Background: Lumen-apposing metal stents (LAMS) may be inserted to create gastrointestinal anastomoses under endoscopic ultrasound (EUS) guidance. This new technique has mostly been evaluated as treatment for gastric outlet obstruction (GOO), especially of malignant origin. Technical success was high in the few and small available studies. Read More

Z Gastroenterol 2020 Apr 30;58(4):352-356. Epub 2020 Apr 30.

Gastroenterology, Universitätsspital Zürich, Zürich, Switzerland.

Bouveret's syndrome is a rare complication resulting from gallstone disease. Both surgical and endoscopical procedures are performed, with the disease to be seen as strictly interdisciplinary. There are no well-established recommendations for this condition. Read More

Clin Imaging 2020 Apr 19;65:37-46. Epub 2020 Apr 19.

Pediatric Radiology, Soroka University Hospital, Ben Gurion University, Israel; Department of Pediatric Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, United States of America. Electronic address:

Upper gastrointestinal obstruction (UGIO), obstruction occurring at the level of the stomach or duodenum, represents only about 5% of bowel obstructions. As with other bowel obstructions, timely diagnosis is necessary to prevent complications including ischemia and death. Because the presenting symptoms of UGIO can be vague and nonspecific, the diagnosis may not be suspected clinically. Read More

ACG Case Rep J 2020 Mar 19;7(3):e00344. Epub 2020 Mar 19.

Department of Gastroenterology, University of Illinois at Chicago, Advocate Christ Medical Center, Oak Lawn, IL.

Eosinophilic enterocolitis is a rare condition representing the least frequent manifestation of eosinophilic gastrointestinal disorders. We report a 49-year-old man who presented with abdominal pain, diarrhea, and intractable vomiting for 2 weeks. Abdominal computed tomography demonstrated gastric wall thickening with mural wall thickening of the small intestine and colon. Read More

Surg Endosc 2020 Apr 22. Epub 2020 Apr 22.

Department of Surgical Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.

Background: Lumen apposing metal stent (LAMS) allows an easy access to peripancreatic fluid collections (PPFCs) and the possibility of performing direct endoscopic necrosectomy (DEN). The aim of our study was to evaluate the safety and efficacy of a new 20-mm LAMS in the management of PPFCs. This novel stent represents the largest diameter LAMS available on the market to date. Read More

Obes Surg 2020 Jul;30(7):2856-2857

Department of General and Digestive Surgery, Hospital Universitario de Guadalajara, Calle Donante de sangre s/n., 19002, Guadalajara, Spain.

Introduction: Recently, some surgical teams have used a laparoscopic vertical clip gastroplasty to treat morbid obesity. This approach mimics the principle of laparoscopic sleeve gastrectomy, but using a completely reversible mechanism. Displacement of the device has been reported in 7. Read More

Proc (Bayl Univ Med Cent) 2020 Apr 10;33(2):235-236. Epub 2020 Jan 10.

Department of Gastroenterology, Upstate Medical UniversitySyracuseNew York.

Biliary-enteric fistula is a rare complication of cholelithiasis that can lead to gallstone ileus. Gallstone impaction in the duodenum and pylorus is extremely rare and can lead to gastric outlet obstruction, a condition known as Bouveret syndrome. Bouveret syndrome needs to be diagnosed and managed in a timely fashion, as it has a high mortality rate. Read More

Dis Mon 2020 Apr 17:100986. Epub 2020 Apr 17.

Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.

Pancreatic fluid collections (PFC), including pancreatic pseudocysts and walled-off pancreatic necrosis, are a known complication of severe acute pancreatitis. A majority of the PFCs remain asymptomatic and resolve spontaneously. However, some PFCs persist and can become symptomatic. Read More