Indian Journal of Gastroenterology
Permanent URI for this collection
Browse
Recent Submissions
Item Gastroenterology Elsewhere.(2009-11) Patil, Prachi; Shah, SundeepItem Use of Venflon Branule needle for aspiration of liver abscesses.(2009-11) Kaya, MuhsinItem Inflammatory bowel disease in infancy.(2009-11) Uslu, Nuray; Usta, Yusuf; Balamtekin, Necati; Demir, Hulya; Saltik-Temizel, Inci Nur; Yüce, AyselItem Glutaraldehyde-induced colitis: three case reports.(2009-11) Kurdas, Oya Övünç; Sezikli, Mesut; Çetinkaya, Züleyha Akkan; Güzelbulut, Fatih; Yasar, Bülent; Cosgun, Süleyman; Degirmenci, Ayça SaltürkItem Anatomy of retrohepatic segment of inferior vena cava and termination of hepatic veins.(2009-11) Joshi, S D; Joshi, S S; Siddiqui, A UBackground Information on anatomy of intrahepatic inferior vena cava (IVC) and hepatic vein openings in it is limited. Methods We studied the retrohepatic segment of IVC and hepatic vein openings in it in 69 livers obtained from cadavers. The retrohepatic portion of the IVC was opened posteriorly by a vertical cut, the exposed surface was divided into 12 quadrants and the position, size, and septation of ostia of hepatic veins and any accessory openings were charted; measurements were made using Vernier calipers. Results The median length of the intrahepatic IVC was 5.7 (range 3.3–8.2) cm and its median diameter was 2.3 (range 1.5–3.0) cm. The superior (major) set of hepatic veins comprised of two veins (right and left-middle) in 45 (65%) cases, three veins (right, middle, and left) in 23 (33%) and four veins in one (2%) case. Median diameter of the right hepatic vein was 1.5 (range 0.8–2.7) cm and that of left hepatic vein was 1.2 (0.7–2.6) cm. Middle hepatic vein, when separate, had a median diameter of 1.1 (range 0.5–1.5) cm. The inferior (minor) set of hepatic veins had two to 16 (median 7) veins. Conclusions Our data provide information on number, size, position, and septation of hepatic vein openings into the IVC. This information may be useful to hepatologists, hepatic surgeons while planning segmental resection of the liver, and to radiologists planning diagnostic and interventional procedures on hepatic venous system.Item Colorectal cancer distribution in 220 Indian patients undergoing colonoscopy.(2009-11) Peedikayil, Musthafa Chalikandy; Nair, Prem; Seena, S M; Radhakrishnan, Lakshmi; Sadasivan, Shine; Naryanan, V A; Balakrishnan, VAim Colorectal cancer is one of the major cancers in the developed world. The incidence of colorectal cancer is low in India. The aim of the present study was to describe the anatomical distribution and age at diagnosis of colorectal cancer in India. Methods Retrospective descriptive analysis of anatomical distribution, age at diagnosis and demography of 220 cases (149 [67.7%] men) of adenocarcinoma of the colon or rectum diagnosed at colonoscopy over a period of five years. Results The mean age at diagnosis was 58.4 years (SD 13.3; range 23–85 years). Twenty-eight (12.7%) cases were below the age of 40 years. The majority (31.8%) cases were aged between 61–70 years. Most of the tumors (n=163, 74%) were located distal to the splenic flexure. Multivariate logistic regression analysis showed that bleeding per rectum (OR 2.8; 95% CI 1.2-6.2) was associated with distal cancer, and palpable mass (OR 3.9; 95% CI 1.7–8.6) was associated with proximal cancer. Conclusions Almost one-third of the colorectal cancers in this series occurred in the seventh decade and were located distal to the splenic flexure.Item Natural history of bleeding after esophageal variceal eradication in patients with extrahepatic portal venous obstruction; a 20-year follow-up.(2009-11) Thomas, Varghese; Jose, Tony; Kumar, SunilBackground Long-term follow-up studies of patients with extrahepatic portal venous obstruction (EHPVO) after eradication of esophageal varices using endoscopic sclerotherapy (EST) are limited. Methods Between 1985 and 1994, 223 patients with bleeding esophageal varices due to EHPVO underwent variceal eradication using EST. Regular annual clinical and endoscopic follow-up data were available for 198 of these patients for a mean period of 19.8 (range: 14–23) years. These data were analyzed retrospectively. Results Of the 198 patients, 34 (17.2%) had rebleeding after variceal eradication. The mean duration from variceal eradication to recurrence of bleeding was 5.4 years. The causes of rebleeding were: recurrent esophageal varices in 21 patients, fundal varices in eight, portal gastropathy in three, and ectopic varices in two patients. Esophageal varices reappeared in 39 (19.7%) patients. Fundal varices appeared in 19 (9.5%) patients during follow-up. Conclusions EST is an effective treatment modality for bleeding esophageal varices due to EHPVO. During a follow- up of nearly 20 years after variceal eradication, only about one-sixth of the patients had recurrence of gastrointestinal bleeding. Bleeding was unusual after 10 years had passed since initial variceal eradication.Item Multidetector computed tomographic findings in jejunogastric intussusception.(2009-11) Mahmood, N S; Rai, R; Suresh, H B; D’Souza, SItem Fecal elastase1 and acid steatocrit estimation in chronic pancreatitis.(2009-11) Girish, Banavara Narasimhamurthy; Rajesh, Gopalakrishna; Vaidyanathan, Kannan; Balakrishnan, VallathBackground Measurement of pancreatic exocrine function and steatorrhea in chronic pancreatitis in the clinical setting has not received much attention. Aim To assess pancreatic exocrine function and fecal fat excretion in a cohort of patients with chronic pancreatitis. Methods Stool elastase1 levels were measured in 101 patients using polyclonal ELISA and acid steatocrit was measured in 86 chronic pancreatitis patients. Associations with etiology, clinical and radiological features, and diabetic status were examined. Results Low pancreatic stool elastase1 (<200 μg/g stool) was observed in two-thirds of chronic pancreatitis patients and correlated with ductal dilatation, pancreatic atrophy and calcification (p<0.05). Diabetes was more prevalent in chronic pancreatitis patients with low elastase1 (p=0.045). There was no difference in mean acid steatocrit between diabetics and non-diabetics (p=0.069). Elastase1 levels had a negative correlation with acid steatocrit (r=–0.606, p<0.001), and a positive correlation (r=0.412) with body mass index (p=0.013). Fiftythree percent of chronic pancreatitis patients with normal BMI had low elastase1. Conclusions Fecal elastase1 levels correlated with fecal fat excretion and BMI. Fecal elastase1 estimation may be helpful in early detection of malabsorption in chronic pancreatitis.Item Extrahepatic portal venous obstruction: Is the knife irrelevant.(2009-11) Pal, Sujoy; Sahni, PeushItem Cystic lymphangioma of the colon.(2009-11) Kulkarni, Jayashree; Bhat, Naresh; Pai, Sanjay AItem The steatocrit as a measure of fecal fat excretion: uses and pitfalls.(2009-11) Ramakrishna, B SItem Gastroenterology elsewhere.(2009-09) Patil, Prachi; Shah, SundeepItem Use of linseed oil in preventing peri-ileostomy skin excoriation.(2009-09) Saxena, Sunil; Suryawanshi, Seema; Somashekar, Uday; Sharma, DhananjayaItem Celiac disease, still an uncommon problem in Tamilians.(2009-09) Ganesh, R; Suresh, N; Sathiyasekaran, MItem Pancreatitis, polyarthritis, panniculitis syndrome’ (PPP syndrome) plus prolonged pyrexia–a rare presentation of chronic pancreatitis.(2009-09) Jose, Tony; Biju, I K; Kumar, Anish; Anver, P C; Kuruvila, Rojan; Kuruvila, Shalini; Lilly, MPancreatitis presenting without abdominal pain is very unusual. Here we report a 70-year-old man with chronic calcific pancreatitis presented to us with prolonged fever, arthritis and multiple subcutaneous swellings, but without any abdominal pain or other abdominal symptoms. His serum amylase and lipase were very high. Biopsy from the subcutaneous swellings revealed fat necrosis and CT scan abdomen showed features of chronic calcific pancreatitis. He was managed conservatively with supportive measures, and recovered. There is only scanty information in literature regarding this type of presentation in chronic pancreatitis.Item Role of ultrathin transnasal esophagogastroduodenoscopy: experience with 50 patients.(2009-09) Seth, Avnish Kumar; Puri, Pankaj; Chandra, AlokConventional gastroscopes have a diameter of 8.8–12 mm; ultrathin endoscopes have an outer diameter of 5.3–5.9 mm. We share our experience with 50 patients who underwent transnasal esophagogastroduodenoscopy using an ultrathin endoscope. The indications included endoscopyassisted nasogastric tube placement in 25 patients, tight lesions not negotiable with conventional endoscope in 9, restricted mouth opening in 9, corrosive injury in 3, restricted cervical spine movement in 2 and altered sensorium following cerebrovascular accident in 2 patients. Transnasal esophageal intubation failed in 1 patient each with oropharyngeal malignancy and lipoma annularis coli. Wire-guided naso-jejunal tube placement was done in 2 patients and transnasal percutaneous endoscopic gastrostomy was done in 1 patient. Two patients developed self-limiting epistaxis. Ultrathin transnasal esophagogastroduodenoscope is a useful tool in endoscopy units, particularly those dealing with oncology patients. Inability to deliver endotherapy due to small diameter of the working channel is a limitation.Item Role of intravenous naloxone in severe pruritus of acute cholestasis.(2009-09) Joshi, Gunjan G; Thakur, B S; Sircar, Shohini; Namdeo, Arvind; Jain, Ajay KPruritus is a well-known manifestation of various cholestatic disorders. Increased opioidergic tone is one of the mechanisms for this. This prospective, uncontrolled study was done to determine the efficacy of intravenous naloxone in pruritus of acute cholestasis. Twenty-two patients with severe pruritus (based on visual analogue scale [VAS] score of 0–100 and associated symptoms) were treated with intravenous naloxone (0.4 mg every 8 hours) for at least 48 hours. Viral hepatitis E was found to be the most common etiology for cholestatic pruritus (n=12). Eighteen patients (81.8%) patients had significant reduction in VAS after 48 hours of starting naloxone; these patients also showed reduction in alkaline phosphatase and gamma glutamyl transpeptidase. There was no side-effect or ‘breakthrough’ phenomenon noted in any patient over next 6 weeks. Naloxone is safe and efficacious in symptomatic improvement in cholestatic pruritus.Item vacA genotypes in Helicobacter pylori strains isolated from patients with and without duodenal ulcer in Bahrain.(2009-09) Bindayna, Khalid Mubarak; Mahmeed, Ali AlBackground The vacuolating cytotoxin and the cytotoxinassociated protein, encoded by vacA and cagA, respectively, are important virulence determinants of Helicobacter pylori. Objective The aim of this study was to perform vacA genotyping and evaluate its association with cagA genotype and clinical outcome. Methods One hundred and twenty H. pylori strains were isolated from dyspeptic patients (29 with peptic ulcer, 91 with non-ulcer dyspepsia). Genotype was determined by PCR. Results Seventy-nine (66%) of 120 strains had the vacA signal sequence genotype s1 and 41 (34%) had the type s2. The vacA middle-region types m1 and m2 were detected in 56 (47%) and 64 (53%) strains, respectively. The combinations s1–m1 (n=56 [47%] and s2–m2 (41 [34%]) occurred more frequently than s1–m2 (23 [19.2%]; p=0.001). No strain with the combination s2–m1 was found. All patients with peptic ulcers harbored type s1 strains compared to 75 (82.4%) of 91 patients with non-ulcer dyspepsia (p=0.01). The vacA genotype s1 was associated with the presence of cagA (p <0.0001). The cagA gene was detectable in 38 (31.6%) of 120 isolates and present in all 29 patients with ulcer compared to nine of 91 with non-ulcer dyspepsia (p <0.001). Conclusion Helicobacter pylori strains of vacA type s1 and the combination of s1–m1 were associated with peptic ulceration and the presence of cagA gene.Item Absence of Mycobacterium avium ss paratuberculosis-specific IS900 sequence in intestinal biopsy tissues of Indian patients with Crohn’s disease.(2009-09) Sasikala, Mitnala; Reddy, D Nageshwar; Pratap, Nitesh; Sharma, Sanjeev Kumar; Reddy, P Balkumar; Sekaran, Anuradha; Banerjee, Rupa; Reddy, D BhaskaraBackground and Objective The role of Mycobacterium avium ss paratuberculosis (MAP) in the etiopathology of Crohn’s disease (CD) remains controversial, because of conflicting reports demonstrating the presence of MAP-specific insertion sequence from intestinal biopsy tissues of patients clinically diagnosed for the disease. The present study was carried out to investigate the presence of MAP DNA in the intestinal tissues of CD patients to ascertain the relevance of MAP in Indian patients with CD. Methods Patients diagnosed as CD at our institute were recruited. Healthy individuals without inflammatory bowel disease served as controls. Mucosal biopsy specimens were collected from ileum and colon in duplicates and subjected to histopathological examination and polymerase chain reaction (PCR) amplification. Total DNA (81 CD patients, 85 healthy individuals) and total RNA (12 CD patients, 12 healthy individuals) isolated from tissue specimens was used for amplification of MAP-specific IS900 by nested PCR. Results MAP-specific IS900 DNA and RNA could not be detected by nested PCR in the intestinal tissues of any patient with CD. Conclusion Our results do not support the etiological role of MAP in the pathogenesis of CD in Indian patients.