2017 · CGH · Podcast

GI Pearls – October 16 – November 10 2017 – Episode 12

Show Notes for October 16- November 10 – Episode 12

  1. A comparison of the resection rate for cold and hot snare polypectomy for 4–9 mm colorectal polyps: a multicentre randomised controlled trial  – GUT.
  2. Impact of preprocedure simethicone on adenoma detection rate during colonoscopy – Endoscopy
  3. Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn’s disease: a randomised controlled, open-label, multicentre trial – The Lancet – Gastro
  4. Modifiable factors associated with patient-reported pain during and after screening colonoscopy – Gut
  5. Accuracy and Safety of the Cytosponge for Asessment of Histologic Activity in EOE: Two center study – Am J Gastro
  6. Air Insufflation May Still be Ideal For Adenoma Detection – Am J Gastro
  7. Patients with Crohn’s Disease with High Body Mass Index Present More Frequent and Rapid Loss of Response to Infliximab – IBD journal
  8. Anesthesia Assistance in outpatient colonoscopy and risk of aspiration pneumonia, bowel perforation, and splenic injury. – Gastro
  9. Increased Risk for Mother-to-Infant Transmission of HCV Among Medicaid Recipience – Wisconsin – MMWR
  10. Upper gastrointestinal complications following ablation therapy for atrial fibrillation – NeuroGastro&Motility
  11. Hemorrhagic angiodysplasia of the digestive tract – GIE
  12. Colorectal cancer screening with the fecal immunochemical test in persons aged 30 to 49 years: focusing on the age for commencing screening – GIE
2017 · Podcast

GI Pearls – September 1-15 2017 – Episode 9

Show Notes for September 1-15 2017  Episode 009
  1. Asthma Is Associated With Subsequent Development of Inflammatory Bowel Disease: A Population-based Case–Control Study  – CGH
  2. Laboratory predictors of bleeding and the effect of platelet and RBC transfusions on bleeding outcomes in the PLADO trial – Blood
  3. Therapeutic endoscopy-related GI bleeding and thromboembolic events in patients using warfarin or direct oral anticoagulants: results from a large nationwide database analysis – Gut
  4. Major Bleeding Risk During Anticoagulation with Warfarin, Dabigatran, Apixaban, or Rivaroxaban in Patients with Nonvalvular Atrial Fibrillation. – J of Managed Care & Spec Pharm
  5. Oral administration of conditioned medium obtained from mesenchymal stem cell culture prevents subsequent stricture formation after esophageal submucosal dissection in pigs. – GIE
  6. High Dietary Intake of Specific Fatty Acids Increases Risk of Flares in Patients With Ulcerative Colitis in Remission During Treatment With Aminosalicylates – CGH
  7. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Inherited Polyposis Syndromes – Dis of Col and Rectum.
  8. Measurement Bias of Polyp Size at Colonoscopy – Dis of Col and Rectum.
  9. Chronic Pancreatitis and Pancreatic Cancer Risk: A Systematic Review and Meta-analysis – Am J Gastro.
  10. Rural and Urban Residence During Early Life is Associated with Risk of Inflammatory Bowel Disease – AmJGastro
  11. What’s new in Rome IV – Neurogastro & Motility
  12. Fecal Calprotectin Levels Predict Histological Healing in Ulcerative Colitis – IBD Journal
  13. Weight and Metabolic Outcomes 12 Years after Gastric Bypass – NEJM
2017 · CGH · Podcast · Study

GI Pearls Episode 5 – Last two weeks of June 2017

Show Notes for 2017 Second two weeks of June 005
  1. Cost Utility Analysis of Topical Steroids Compared With Dietary Elimination for Treatment of Eosinophilic Esophagitis – CGH
  2. Incidence and Prevalence of Crohn’s Disease and Ulcerative Colitis in Olmsted County, Minnesota From 1970 Through 2010 – CGH
  3. Fecal Immunochemical Test Detects Sessile Serrated Adenomas and Polyps With a Low Level of Sensitivity – CGH
  4. Comparison of Two Intensive Bowel Cleansing Regimens in Patients With Previous Poor Bowel Preparation: A Randomized Controlled Study. – GIE
  5. Acute Fatty Liver Disease of Pregnancy: Updates in Pathogenesis, Diagnosis, and Management – ACG
  6. Disentangling the Association between Statins, Cholesterol, and Colorectal Cancer: A Nested Case-Control Study – PLOS Medicine
  7. Association of Gastric Acid Suppression With Recurrent Clostridium difficile InfectionA Systematic Review and Meta-analysis – JAMA Internal Med
  8. Amanita phalloides Mushroom Poisonings — Northern California, December 2016 – MMWR June 2017
  9. Wild Mushrooms: An Exclusive Delicacy or Last Meal – ACG
  10. Treatment of NASH: What Helps Beyond Weight Loss? – ACG
  11. Small intestinal bacterial overgrowth and Celiac disease: A systematic review with pooled-data analysis – Neurogastro & Motility
Uncategorized

Right-sided colonic ischemia with and without acute mesenteric ischemia

One of the most frustrating calls that I remember getting from ED was related to general confusion between colonic ischemia and acute mesenteric ischemia. It would be a resident calling stating that the Lactate is normal, but “all signs point to mesenteric ischemia” even though there is no abdominal pain, stable vitals, and more often than not no co-morbidities, and reassuring imaging. Which drew my attention to this article, which examined patients with biopsy-proven Right-sided Colonic Ischemia alone or in combination with Acute Mesenteric Ischemia(confirmed by imaging or surgical evaluation of small bowel).

Summary:

  1. IRCI + AMI = disaster. Mortality of ~90%.
  2. BUN and WBC count can be used to differentiate those with acute mesenteric ischemia to those without ( BUN would be high – above 35, and WBCs will be high as well  – above 20). Nothing new here, but nice to see this in another study. We already know that CT alone can be used as well.
  3. 15% of cases of Right-sided Colon ischemia will have Acute Mesenteric Ischemia as well – so look for it, since it is such a disaster, with almost all patients undergoing surgical resection of some sort.
  4.  COPD  may be associated with development of AMI, and poor outcomes in Colonic Ischemia in general.

The article is written by the folks from Connecticut as well as Montefiore Hospital, which bailed out my Medical School recently.