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Cureus 2022 May 21;14(5):e25191. Epub 2022 May 21.

Internal Medicine, MedStar Washington Hospital Center, Washington, USA.

Spontaneous pneumothorax is a pneumothorax that is not caused by trauma or an apparent precipitating factor. This report presents a case of a 91-year-old man with no history of lung disease who developed pneumothorax after two days of persistent nausea and vomiting. He was misdiagnosed as a case of Boerhaave's syndrome. Read More

Korean J Gastroenterol 2022 Jun;79(6):260-264

Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea.

A 52-year-old woman with a gastric outlet obstruction (GOO) caused by pyloric cancer underwent pyloric endoscopic self-expandable metal stent (SEMS) insertion. She presented with abdominal distension 40 days later. The SEMS was dysfunctional, and endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) was performed using an endoscopic nasobiliary drainage tube. Read More

J Indian Assoc Pediatr Surg 2022 May-Jun;27(3):287-292. Epub 2022 May 12.

Department of Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

Background: Gastrointestinal (GI) malformations have varied short-term and long-term outcomes reported across various neonatal units in India.

Methods: This descriptive study was done to study the clinical profile, outcomes and predictors of mortality in neonates operated for congenital GI malformations in a tertiary neonatal care unit in South India between years 2011 and 2020. Details were collected by retrospective review of the case sheets. Read More

Arq Bras Cir Dig 2022 17;35:e1654. Epub 2022 Jun 17.

Department of Surgery, University Hospital, University of Chile - Santiago - Chile.

Aim: Small bowel obstruction (SBO) is a frequent cause of emergency department admissions. This study aimed to determine risk factors of reoperations, postoperative adverse event, and operative mortality (OM) in patients surgically treated for SBO.

Methods: This is a retrospective study conducted between 2014 and 2017. Read More

Dig Endosc 2022 Jun 20. Epub 2022 Jun 20.

Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.

Background: Both clinical experience and supporting data have improved drastically in the context of EUS-gastrointestinal anastomosis (EUS-GIA). Where outcomes used to be questioned, focus has now moved towards performing comparative studies, optimizing technical approaches, improving patient selection and developing well-defined treatment algorithms.

Methods: The purpose of this review is to provide an overview of technical developments within EUS-GIA, discuss the current status of EUS-GIA and future directions. Read More

BMC Gastroenterol 2022 Jun 20;22(1):300. Epub 2022 Jun 20.

Department of Surgery, Valleywise Health Medical Center, Phoenix, AZ, USA.

Background: Small intestinal bacterial overgrowth (SIBO) is a condition of unknown prevalence characterized by an excessive amount of bacteria in the small bowel, typically resulting in vague gastrointestinal symptoms with bloating being most commonly reported. Here we describe a severe case of SIBO leading to small bowel necrosis requiring surgical intervention.

Case Presentation: A 55-year-old Hispanic female with gastric outlet obstruction secondary to a newly diagnosed gastric adenocarcinoma, receiving neoadjuvant chemotherapy, developed bloody gastrostomy output and rapidly progressing nausea and abdominal distention 3 days after jejunostomy tube placement and initiation of jejunal enteral nutrition. Read More

J Community Hosp Intern Med Perspect 2022 31;12(1):39-42. Epub 2022 Jan 31.

Department of Gastroenterology, Blanchard Valley Health System, Findlay, OH, USA.

We are presenting a rare case of pyloric stenosis due to Crohn's disease. A 53-year-old woman with prior history of colonic Crohn's disease was admitted to the hospital with gastric outlet obstruction. Esophagogastroduodenoscopy demonstrated pyloric stenosis and biopsy was consistent with Crohn's disease. Read More

Dig Liver Dis 2022 Jun 13. Epub 2022 Jun 13.

Department of Gastroenterology, Nizam's Institute of Medical Sciences, 4th Floor, Specialty block, Panjagutta, Hyderabad 500082, India.

Sci Rep 2022 Jun 13;12(1):9746. Epub 2022 Jun 13.

Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Endoscopic duodenal stent (DS) placement for malignant gastric outlet obstruction (GOO) is rapidly increasing in clinical practice; however, the most suitable patient candidates for DS placement have not been determined. One hundred and thirty-five patients with GOO who underwent DS placement in three Japanese referral centers between January 2010 and October 2019 were retrospectively evaluated. Overall survival (OS) after DS placement, technical/clinical success rates, adverse events, and predictive factors affecting OS after DS placement were also analyzed. Read More

VideoGIE 2022 Jun 17;7(6):223-225. Epub 2022 Mar 17.

Endoscopy Unit, Hospital Nossa Senhora das Graças, Curitiba, Brazil.

Video 1Magnetic compression anastomosis for the treatment of complete gastric outlet obstruction. Read More

Endosc Int Open 2022 Jun 10;10(6):E874-E897. Epub 2022 Jun 10.

Department of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, Washington, United States.

Malignant disease accounts for up to 80 % of gastric outlet obstruction (GOO) cases, which may be treated with duodenal self-expanding metal stents (SEMS), surgical gastrojejunostomy (GJ), and more recently endoscopic-ultrasound-guided gastroenterostomy (EUS-GE). These three treatments have not been compared head-to-head in a randomized trial. We searched the Embase and MEDLINE databases for studies published January 2015-February 2021 assessing treatment of malignant GOO using duodenal SEMS, endoscopic (EUS-GE) or surgical (laparoscopic or open) GJ. Read More

Endosc Int Open 2022 Jun 10;10(6):E832-E839. Epub 2022 Jun 10.

Johns Hopkins Hospital, Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States.

Gastroparesis post-lung transplant (LTx) can lead to increased risk of gastroesophageal reflux (GER) and accelerated graft dysfunction. We aimed to evaluate the efficacy and safety of gastric per-oral endoscopic myotomy (G-POEM), a promising tool in patients with refractory gastroparesis, for managing refractory gastroparesis and GER in post-LTx patients. This was a multicenter retrospective study on post-LTx patients who underwent G-POEM for management of gastroparesis and GER that were refractory to standard medical therapy. Read More

NEJM Evid 2022 Apr 17;1(4):EVIDoa2100054. Epub 2022 Mar 17.

Francis I Proctor Foundation, University of California, San Francisco, USA.

Background: Biannual mass azithromycin administration reduces all-cause childhood mortality in some sub-Saharan African settings, with the largest effects in children aged 1-5 months. Azithromycin has not been distributed to children <1 month due to risk of infantile hypertrophic pyloric stenosis (IHPS).

Methods: This 1:1 placebo-controlled trial, randomized neonates aged 8-27 days to a single oral dose of azithromycin (20 mg/kg) or equivalent volume of placebo in 5 regions of Burkina Faso during 2019 and 2020. Read More

Cureus 2022 May 6;14(5):e24768. Epub 2022 May 6.

Breast Surgery, Basildon and Thurrock University Hospital, Mid and South Essex NHS Foundation Trust, Basildon, GBR.

Bouveret syndrome is a subtype of gallstone ileus, wherein a calculus becomes entrapped in the duodenum via a cholecystocolic fistula, leading to gastric outlet obstruction. Due to the non-specific symptoms the patients present with, a diagnosis is reliant on computed tomography (CT), magnetic resonance imaging (MRI) or direct endoscopic visualisation. We report a case of Bouveret syndrome and review current literature, outlining the aetiopathogenesis and management strategies of this condition. Read More

BMC Surg 2022 Jun 7;22(1):218. Epub 2022 Jun 7.

Department of Pediatric Surgery, West China Hospital of Sichuan University. #37 Guo-Xue-Xiang, Chengdu, 610041, Sichuan, China.

Purpose: A new novel technique for the treatment of pediatric hypertrophic pyloric stenosis (HPS), transumbilical single-site laparoscopic pyloromyotomy with a single instrument (TUSSLP), was introduced. TUSSLP was compared with the transabdominal three-site laparoscopic pyloromyotomy (TATSLP) procedure.

Methods: Patients with HPS who underwent TUSSLP and TATSLP between January 2016 and September 2020 were assigned to group A and group B, respectively. Read More

J Pediatr Gastroenterol Nutr 2022 Jun 6. Epub 2022 Jun 6.

Professor, Department of Pediatric Surgery, IMS and SUM Hospital, Bhubaneswar, Odisha, India.

Int J Surg Case Rep 2022 May 14;94:107084. Epub 2022 Apr 14.

General Surgery Department, Croydon University Hospital, London CR7 7YE, United Kingdom. Electronic address:

Introduction And Importance: Bouveret syndrome is a rare condition characterised by gastric outlet obstruction secondary to a gallstone fistulating into the proximal duodenum or pylorus. Although rare, this condition carries a high mortality rate and no current standardised guidelines for management.

Case Presentation: We present a case of a patient in their 60s with recurrent small bowel obstruction secondary to a cholecysto-duodenal fistula and large gallstone which became impacted in the fourth part of the duodenum. Read More

Langenbecks Arch Surg 2022 Jun 1. Epub 2022 Jun 1.

Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Kuntokatu 2, 33520, ElämänaukioTampere, Finland.

Background: Surgical gastrojejunostomy has traditionally been the palliative treatment of choice for patients with advanced malignancies and gastric outlet obstruction syndrome. Recently, palliative endoscopic duodenal stenting has increased in popularity. We report outcomes after gastrojejunostomy and duodenal stenting when used for palliative indications. Read More

Kans J Med 2022 17;15:194-196. Epub 2022 May 17.

Department of Internal Medicine, Division of Gastroenterology, University of Kansas School of Medicine-Wichita, Wichita, KS.

Rev Esp Enferm Dig 2022 May 31. Epub 2022 May 31.

Gastroenterología y Endoscopia Digestiva, Hospital Universitario UANL, México.

A 32-year-old male with crack-cocaine abuse for 10 years, 300 g/day. He started with epigastric abdominal pain, intensity 10/10, he went to another hospital where a perforated peptic ulcer was suspected and a laparotomy was performed, with no findings. Subsequently, he started with vomiting and weight loss, on admission, a gastric outlet obstruction (GOO) was suspected and CT scan showed a concentric duodenal growth. Read More

PLoS One 2022 25;17(5):e0268920. Epub 2022 May 25.

Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Objectives: Self-expandable metallic stent (SEMS) placement is a safe and effective palliative treatment for malignant gastric outlet obstruction; however, the clinical outcomes of gastric and duodenal stenoses may differ. This study aimed to investigate the clinical efficacy of SEMS placement and the predictors of clinical outcomes, specifically in malignant duodenal obstruction (MDO).

Methods: Between September 2009 and March 2021, 79 patients with MDO who received SEMS placement in our hospital were retrospectively enrolled. Read More

Case Rep Gastroenterol 2022 Jan-Apr;16(1):247-251. Epub 2022 Apr 7.

Surgical Faculty, University of California Riverside, Riverside, California, USA.

Bouveret's syndrome is an unusual clinical presentation of gastric-outlet obstruction and is the most infrequent variant of gallstone ileus with just over 300 cases in the literature. A 73-year-old female presented with innocuous constitutional symptoms and was found to have Mirizzi type Vb, a cholecystoduodenal fistula with obstruction. Esophago-gastroduodenoscopy-attempted dislodgement was unsuccessful. Read More

BMC Gastroenterol 2022 May 21;22(1):257. Epub 2022 May 21.

Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.

Background: Metallic stents placed in the descending duodenum can cause compression of the major duodenal papilla, resulting in biliary obstruction and pancreatitis. These are notable early adverse events of duodenal stent placement; however, they have been rarely examined. This study aimed to assess the incidence of and risk factors for biliary obstruction and/or pancreatitis after duodenal stent placement in the descending duodenum. Read More

Cureus 2022 Apr 16;14(4):e24187. Epub 2022 Apr 16.

Radiology and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, IND.

Mirizzi and Bouveret syndromes are uncommon but important complications of calculous cholecystitis. Mirizzi syndrome commonly presents with jaundice due to extrinsic compression on the common bile duct by an impacted stone at the gall bladder infundibulum, whereas Bouveret syndrome presents with gastric outlet obstruction due to a large stone in the duodenum. Our case is a 65-year-old lady who presented with pain in the right upper abdomen associated with nausea and vomiting. Read More

Avicenna J Med 2022 Jan 2;12(1):34-37. Epub 2021 Dec 2.

Gastroenterology Division, Wayne State University, Detroit, Michigan, United States.

Large gallstones could erode through gallbladder wall to nearby structures, causing fistulas, gastric outlet obstruction and gallstone ileus. They typically occur in elderly patients with comorbidities carrying therapeutic challenges. We present a case of a middle-aged woman who was thought to have symptomatic cholelithiasis. Read More

World J Gastroenterol 2022 Apr;28(14):1455-1478

Section of Hepatobiliary-Pancreatic and GI Surgery, Washington University St. Louis, St. Louis, MO 63110, United States.

Background: Heterotopic pancreas (HP) is an aberrant anatomic malformation that occurs most commonly in the upper gastrointestinal tract. While the majority of heterotopic pancreatic lesions are asymptomatic, many manifest severe clinical symptoms which require surgical or endoscopic intervention. Understanding of the clinical manifestations and symptoms of HP is limited due to the lack of large volume studies in the literature. Read More

J Pediatr Surg 2022 Apr 18. Epub 2022 Apr 18.

Institution of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden; Department of Pediatric Surgery, Akademiska Sjukhuset, Uppsala S-75185, Sweden.

Purpose: Pyloromyotomy for pyloric stenosis is one of the more common surgical procedures performed on infants. The long-term effects of the procedure are however unclear. The purpose of this study was to study the effects into adult life, compare them with controls and to see if there is a need for structured follow up of patients. Read More

Cureus 2022 Apr 13;14(4):e24092. Epub 2022 Apr 13.

Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, Kolkata, IND.

Solid pseudopapillary neoplasm (SPN) of the pancreas are rare tumors accounting for a minor portion of all exocrine pancreatic tumors. It usually occurs in young women. It has a very low malignant potential with a relatively indolent clinical course. Read More

Cureus 2022 Apr 13;14(4):e24095. Epub 2022 Apr 13.

General Surgery, Barking, Havering and Redbridge University Hospitals National Health Service (NHS) Trust, Romford, GBR.

Distal duodenal obstruction (DDO) can be succinctly defined as features of gastric outlet obstruction with bilious vomiting and radiological or endoscopic evidence of post-bulbar obstruction. Obstructions of the third (D3) and fourth (D4) parts of the duodenum are rare and present significant diagnostic and surgical challenges, particularly when the cause is malignant. In the following three case reports, we discuss three distinct aetiologies of this rare syndrome and highlight important considerations surrounding the early investigation and management of these individuals. Read More

Endosc Int Open 2022 May 13;10(5):E670-E678. Epub 2022 May 13.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States.

Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) is an endoscopic procedure for treating gastric outlet obstruction (GOO). Limited data exist regarding the safety and efficacy of EUS-GJ in patients with malignant GOO with ascites. Thus, we aimed to study the outcomes and safety of EUS-GJ in GOO patients with vs. Read More