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Do Not Miss the Diagnosis: Not All Pink Findings Mean the Same in the Gastrointestinal Tract! GE Port. J. Gastroenterol. Pub Date : 2023-08-11 Jéssica Chaves,Diogo Libânio
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Luminal and Extraluminal Applications of Endoscopic Stenting: A Bright Future for Gastroenterology. GE Port. J. Gastroenterol. Pub Date : 2023-07-21 Joel Ferreira-Silva,Diogo Libânio,Eduardo Rodrigues-Pinto
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Esophageal Stenting: How I Do It. GE Port. J. Gastroenterol. Pub Date : 2023-06-12 Rui Silva
Endoscopic esophageal stent placement is an effective palliative treatment for malignant strictures and has also been successfully used for benign indications, including esophageal refractory strictures and iatrogenic leaks and perforations. Despite several decades of evolution and the wide variety of esophageal stents available to choose from, an ideal stent that is both effective and without adverse
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Severe Acute Liver Injury due to Secondary Hemophagocytic Lymphohistiocytosis: A Case Report GE Port. J. Gastroenterol. Pub Date : 2023-03-30 Cristiana Sequeira, Sara Ramos Lopes, Anabela Neves, Inês Costa Santos, Cláudio Rodrigues Martins, Ana Paula Oliveira
Severe acute liver injury (ALI) is mostly triggered by viral infections and hepatotoxic drugs; however, it can also be seen in systemic diseases. Hemophagocytic lymphohistiocytosis (HLH) is a rare, immune-mediated syndrome that presents as a life-threatening inflammatory disorder affecting multiple organs. Secondary causes occur mainly in the set of malignancy, infection, and autoimmune disease, and
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Eosinophilic Esophagitis on and off Proton Pump Inhibitor GE Port. J. Gastroenterol. Pub Date : 2023-03-21 Vincent Zimmer, Kai Emrich
GE Port J Gastroenterol
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Quality Standards in Upper Gastrointestinal Endoscopy: Can Deep Sedation Influence It? GE Port. J. Gastroenterol. Pub Date : 2023-03-17 Catarina Correia, Nuno Almeida, Raquel Andrade, Mariana Sant’Anna, Cláudia Macedo, David Perdigoto, Carlos Gregório, Pedro Narra Figueiredo
Introduction: According to the guideline published by ESGE/UEG, a high-quality esophagogastroduodenoscopy (EGD) implies the application of some criteria that enable better healthcare outcomes. Although intra-procedural performance measures are dependent on patient factors, there is no reference to sedation practices in the guideline mentioned above. Objective: This study aimed to evaluate whether deep
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EUS-Guided Choledochoduodenostomy after Failed Endoscopic Retrograde Cholangiopancreatography in Distal Malignant Biliary Obstruction GE Port. J. Gastroenterol. Pub Date : 2023-03-13 Isabel Tarrio, Marta Moreira, Tarcísio Araújo, Luís Lopes
Introduction: Malignant biliary obstruction drainage is essential, since jaundice is associated with morbidity and mortality. Endoscopic retrograde cholangiopancreatography (ERCP) is the recommended procedure for biliary drainage, with percutaneous biliary drainage being the classic alternative in cases of unsuccessful ERCP. Recently, endoscopic ultrasound-guided biliary drainage has been emerged as
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Endoscopic Retrograde Cholangiopancreatography on Pediatric Patients: Experience of a Portuguese Adult Gastroenterology Department GE Port. J. Gastroenterol. Pub Date : 2023-03-08 Rita Ornelas Saraiva, Verónica Pavão Borges, Mário Jorge Silva, Rafaela Loureiro, Tiago Capela, Gonçalo Ramos, Jorge Canena, António Mateus Dias, Rui Alves, João Coimbra
Introduction: Experience with endoscopic retrograde cholangiopancreatography (ERCP) in the pediatric population is limited. Few medical centers have experts specifically trained in pediatric therapeutic endoscopy. As a result, patients are generally referred to adult endoscopists with high experience in the procedure. The aim of this study was to characterize the experience of an adult endoscopy unit
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Current Approach to Dysphagia: A Review Focusing on Esophageal Motility Disorders and Their Treatment GE Port. J. Gastroenterol. Pub Date : 2023-03-08
Background: Dysphagia is a prevalent condition which may severely impact the patient’s quality of life. However, there are still lacking standardized therapeutic options for esophageal motility disorders. Summary: Dysphagia is defined as a subjective sensation of difficulty swallowing which can result from oropharyngeal or esophageal etiologies. Regarding esophageal dysphagia, after excluding structural
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Therapeutic Endoscopic Ultrasound: Current Indications and Future Perspectives GE Port. J. Gastroenterol. Pub Date : 2023-02-20 Andrew Canakis, Todd H. Baron
The transcendence of endoscopic ultrasound (EUS) from diagnostic to therapeutic tool has revolutionized management options in the field of gastroenterology. Through EUS-guided methods, pancreaticobiliary obstruction can now be utilized as an alternative to surgical and percutaneous approaches. This modality also allows for gallbladder drainage in patients who are not ideal operative candidates. By
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Embryonal Sarcoma of the Liver in the Adult: Challenges in the Diagnosis of a Rare Entity GE Port. J. Gastroenterol. Pub Date : 2023-02-09
Introduction: Embryonal sarcoma of the liver (ESL) is a rare neoplasm of the liver occurring mainly in paediatric ages. Making the correct diagnosis can be challenging as the laboratory and radiological findings that are often nonspecific, and the tumour immunophenotype is poorly defined and even somewhat variable. Case Presentation: A large epigastric mass was detected in a computerized tomography
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Endoscopic Resection of Gastrointestinal Neuroendocrine Tumors: Safe and Effective GE Port. J. Gastroenterol. Pub Date : 2023-02-06
GE Port J Gastroenterol
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Future Perspectives in the Diagnosis and Treatment of Liver Disease Associated with Alpha-1 Antitrypsin Deficiency GE Port. J. Gastroenterol. Pub Date : 2023-02-01 Nélia Abreu, Vítor Magno Pereira, Madalena Pestana, Luís Jasmins
Alpha-1 antitrypsin deficiency (AATD) is one of the most common genetic diseases and is caused by mutations in the SERPINA1 gene. The homozygous Pi*Z variant is responsible for the majority of the classic severe form of alpha-1 antitrypsin deficiency, which is characterized by markedly decreased levels of serum alpha-1 antitrypsin (AAT) with a strong predisposition to lung and liver disease. The diagnosis
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Endoscopic Submucosal Dissection Is Safe and Effective for Lesions Located at the Anorectal Junction: Analysis from Two Referral European Centers GE Port. J. Gastroenterol. Pub Date : 2023-01-24 Mariana Figueiredo Ferreira, Margarida Marques, Rui Morais, Arnaud Lemmers, Guilherme Macedo, João Santos-Antunes
Introduction: Endoscopic submucosal dissection (ESD) is a well-established resection technique for colorectal superficial tumors, but its role in the treatment of anorectal junction (ARJ) lesions still remains to be determined. With this study, we aimed to evaluate the feasibility, safety, and efficacy of ESD for the resection of ARJ lesions, in comparison to more proximal rectal lesions. Methods:
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Anastomotic Leakages after Surgery for Gastroesophageal Cancer: A Systematic Review and Meta-Analysis on Endoscopic versus Surgical Management GE Port. J. Gastroenterol. Pub Date : 2023-01-24 Isabel Azevedo, Raquel Ortigão, Pedro Pimentel-Nunes, Pedro Bastos, Rui Silva, Mário Dinis-Ribeiro, Diogo Libânio
Introduction: With the increase of esophageal and gastric cancer, surgery will be more often performed. Anastomotic leakage (AL) is one of the most feared postoperative complications of gastroesophageal surgery. It can be managed by conservative, endoscopic (such as endoscopic vacuum therapy and stenting), or surgical methods, but optimal treatment remains controversial. The aim of our meta-analysis
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Ultrarapid Iron Polymaltose Infusions Are Safe for Management of Iron Deficiency GE Port. J. Gastroenterol. Pub Date : 2023-01-19 Iouri Banakh, Martha Turek, Daniel Niewodowski, Rumes Kanna Sriamareswaran, Fiona Yeaman, Lilian Vo, Travis Churchill
Introduction: Iron deficiency is a common condition, especially among patients with kidney and heart failure and inflammatory bowel disease. Intravenous iron is the preferred method of treatment in these patients, but it usually requires prolonged iron polymaltose infusions or multiple administrations of alternative preparations. The aim of the study was to confirm the safety and patient acceptance
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Endoscopic Submucosal Dissection for Resections Larger than 10 cm: Outcomes from a Portuguese Center GE Port. J. Gastroenterol. Pub Date : 2023-01-19 Raquel R. Mendes, Pedro Barreiro, André Mascarenhas, Ana Rita Franco, Liliana Carvalho, Cristina Chagas
Background: Endoscopic submucosal dissection (ESD) is a minimally invasive technique for en bloc resection of superficial neoplastic lesions, independent of their size. However, for giant gastrointestinal superficial neoplasia, the risk of invasive cancer is higher, and ESD is typically challenging. Despite the increasing literature on giant resections, data on their efficacy and safety are still lacking
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Multiple Liver Nodules in Fontan-Associated Liver Disease GE Port. J. Gastroenterol. Pub Date : 2023-01-09 Raquel R. Mendes, Luis Marques, Pedro C. Figueiredo
GE Port J Gastroenterol
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Silent Multiple Lymphomatous Polyposis in Mantle Cell Lymphoma: From the Ileum to the Stoma GE Port. J. Gastroenterol. Pub Date : 2023-01-09 Sofia Bragança, André Pereira, Gonçalo Alexandrino, Filipa Moita, Mariana Nuno Costa, David Horta
GE Port J Gastroenterol
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Refractory Hidradenitis Suppurativa: A Diagnosis to Consider GE Port. J. Gastroenterol. Pub Date : 2023-01-05 Rita Ornelas Saraiva, Christopher Saunders, Margarida Varela dos Santos, Diana Carvalho, Rafaela Loureiro, Jaime Ramos
Hidradenitis suppurativa is a chronic inflammatory disease associated with multiple comorbidities, and its association with lymphoma has recently been a topic of debate. However, it is still controversial whether this risk can be attributed to the disease itself or whether it has any relationship with immunosuppressive treatment. Here, we describe the case of a patient with severe perianal hidradenitis
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Eosinophilic Colitis, an Uncommon Cause of Diarrhea: Case Report and Literature Review GE Port. J. Gastroenterol. Pub Date : 2022-12-21 Pedro Cardoso, Catarina Elias, Renato Medas, Leila Cardoso, Armando Peixoto, Guilherme Macedo, Jorge Almeida
Eosinophilic colitis and hypereosinophilic syndrome with colic involvement are rare diagnosis that are characterized by wide-ranging gastrointestinal symptoms and idiopathic infiltration of eosinophils in the colon. The diagnostic workup is challenging since there are no standardized criteria. We report a case of a man admitted to the hospital with a history of nonbloody chronic diarrhea. The detailed
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The Efficacy and Safety of Treatment Outcomes for Refractory Benign Esophageal Strictures Using a Novel Combination of Needle-Knife Stricturoplasty, Balloon Dilation, and Steroid Injection (with Video) GE Port. J. Gastroenterol. Pub Date : 2022-12-13 Andrew Canakis, Varun Kesar, Benjamin Twery, Osman Ali, Justin Canakis, Caleb Hudspath, Eric M. Goldberg
Background and Aims: Benign esophageal strictures often present with dysphagia and can significantly impair a patient’s quality of life, especially when refractory to standard endoscopic techniques. When repeat dilations fail to achieve an adequate luminal diameter or resolve dysphagia, further therapy with needle-knife or steroid injections is needed. However, patients can still clinically fail. To
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Dysphagia Aortica: An Uncommon and Potentially Life-Threatening Condition GE Port. J. Gastroenterol. Pub Date : 2022-12-13 Francisco Vara-Luiz, Eduardo Fernandes, Fábio Pé D’Arca Barbosa, Ana Albuquerque, Ana Valada Marques, Jorge Fonseca
GE Port J Gastroenterol
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Endoscopic Submucosal Dissection of Subepithelial Lesion in the Cecum: Granular Cell Tumor GE Port. J. Gastroenterol. Pub Date : 2022-12-01 Diogo Bernardo Moura, Nuno Nunes, Carolina Chálim Rebelo, Francisca Côrte-Real, Ana Catarina Rego, Maria Antónia Duarte
GE Port J Gastroenterol
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Endoscopic Approach to Duodenal Adenomas in Familial Adenomatous Polyposis: A Retrospective Cohort GE Port. J. Gastroenterol. Pub Date : 2022-11-29 Joana Lemos Garcia, Isadora Rosa, João Pereira da Silva, Pedro Lage, Isabel Claro
Introduction: Over 90% of the patients with familial adenomatous polyposis (FAP) will develop duodenal adenomas. Aim: The aim of this study was to evaluate the effectiveness and safety of endoscopic excision of large duodenal adenomas in FAP patients. Methods: All FAP patients from a familial risk clinic submitted to endoscopic therapy for duodenal adenomas ≥10 mm between January 2010 and February
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Groove Pancreatitis: Clinical Cases and Review of the Literature GE Port. J. Gastroenterol. Pub Date : 2022-11-29
Introduction: Groove pancreatitis (GP) is a type of chronic segmental pancreatitis that affects the pancreatoduodenal groove area, and it is often misdiagnosed. Outflow obstruction of the minor papilla associated with alcohol consumption seems to be the main pathophysiological mechanism, and it affects mainly middle-aged males. Symptoms include nausea and postprandial vomiting from gastric outlet obstruction
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Successful Endoscopic Closure of Esophageal Perforation in Boerhaave Syndrome Using the Over-the-Scope Clip GE Port. J. Gastroenterol. Pub Date : 2022-11-25
Boerhaave syndrome (BS) is a rare but potentially fatal condition. Although surgery is considered the standard treatment, endoscopic therapy has acquired an important role as a minimally invasive management approach. The authors describe 2 cases of middle-aged male patients, presenting with spontaneous esophageal perforation after severe straining and vomiting. In the first case, the patient presented
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Acknowledgement to Reviewers GE Port. J. Gastroenterol. Pub Date : 2022-11-24
GE Port J Gastroenterol 2022;29:444–445
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Sequential Use of High-Volume Plasma Exchange and Continuous Renal Replacement Therapy in Hepatitis B Virus-Related Acute Liver Failure: A Case Report GE Port. J. Gastroenterol. Pub Date : 2022-11-24 Sofia Bragança, Mário Ferraz, Nuno Germano
Background: Acute liver failure (ALF) may represent an indication for liver transplantation (LT). However, in patients who do not meet the criteria or who have contraindications for LT, support measures remain indicated since they may improve survival. Continuous renal replacement therapy (CRRT) can be considered in the presence of hyperammonemia, 3 times above the upper normal limit, and hepatic encephalopathy
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Gastric Cancer: A Practical Review on Management of Individuals with Hereditary or Familial Risk for Gastric Cancer GE Port. J. Gastroenterol. Pub Date : 2022-11-18 Marisa Linhares, Cláudia Marques Pinto, Diogo Libânio, Manuel R. Teixeira, Mário Dinis-Ribeiro, Catarina Brandão
Gastric adenocarcinoma is one of the most frequent and deadly cancers worldwide. However, its incidence is variable, being higher in eastern countries where screening the general population is recommended. On the other hand, in low to intermediate-risk countries, screening the general population may not be cost-effective, and therefore, it is necessary to be aware of high-risk populations that may
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Autoimmune Liver Disease in Human Immunodeficiency Virus-Infected Patients: 3 Case Series GE Port. J. Gastroenterol. Pub Date : 2022-11-14 Maria Ana Rafael, Filipa Bordalo Ferreira, Rita Theias Manso, Francesca Peruzzu, Mariana Cardoso
We present 3 cases of autoimmune liver disease in human immunodeficiency virus (HIV)-infected patients and describe the different diagnostic and therapeutic approaches used in each case. The first patient was diagnosed with primary biliary cholangitis (PBC) with features of autoimmune hepatitis (AIH), requiring second-line therapy due to incomplete response to ursodeoxycholic acid. The second patient
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Efficacy and Safety of Laparoscopic Endoscopic Cooperative Surgery in Upper Gastrointestinal Lesions: A Systematic Review and Meta-Analysis GE Port. J. Gastroenterol. Pub Date : 2022-11-07 Sara Oliveira de Brito, Diogo Libânio, Cláudia Martins Marques Pinto, João Pedro Pinho Osório de Araújo Teixeira, João Paulo Meireles de Araújo Teixeira
Background and Aims: Laparoscopic and endoscopic cooperative surgery (LECS) combines advantages of endoscopy and laparoscopy in order to resect upper gastrointestinal lesions. Our aim was to evaluate the efficacy and safety of LECS in patients with EGJ (esophagogastric junction), gastric and duodenal lesions, as well as to compare LECS with pure endoscopic and pure laparoscopic procedures. Methods:
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Best Practices in Esophageal, Gastroduodenal, and Colonic Stenting GE Port. J. Gastroenterol. Pub Date : 2022-11-07 Renato Medas, Joel Ferreira-Silva, Mohit Girotra, Monique Barakat, James H. Tabibian, Eduardo Rodrigues-Pinto
Endoscopic stenting is an area of endoscopy that has witnessed noteworthy advancements over the last decade, resulting in evolving clinical practices among gastroenterologists around the world. Indications for endoscopic stenting have progressively expanded, becoming a frequent part of the management algorithm for various benign and malignant conditions of the gastrointestinal tract, from esophagus
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Gastroduodenal and Colorectal Tuberculosis: Report of 2 Cases GE Port. J. Gastroenterol. Pub Date : 2022-11-07 Claudia Alvizuri, Andrea Carlín, Víctor Aguilar, Vanessa Valenzuela
Introduction: Tuberculosis remains a public health concern in developing countries, as well as in developed countries as a result of immigration from endemic areas. Gastroduodenal and colorectal tuberculosis are rare manifestations of gastrointestinal infection. Case Presentation: We present 2 cases of gastric, duodenal, and colorectal tuberculosis. The first case, a 17-year-old male with no medical
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Pharmacological Treatment of Functional Dyspepsia: An Old Story Revisited or a New Story to Be Told? A Clinical Review GE Port. J. Gastroenterol. Pub Date : 2022-11-04 Jéssica Chaves, Inês Pita, Diogo Libânio, Pedro Pimentel-Nunes
Dyspepsia incorporates a set of symptoms originating from the gastroduodenal region, frequently encountered in the adult population in the Western world. Most patients with symptoms compatible with dyspepsia eventually end up, in the absence of a potential organic cause, being diagnosed with functional dyspepsia. Many have been the new insights in the pathophysiology behind functional dyspeptic symptoms