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Topic Review
Elective Early Upper Gastrointestinal Study
Assessment of discomfort as a sign for early postoperative complications in neurologically impaired (NI) children is challenging. The necessity of early routine upper gastrointestinal (UGI) contrast studies following laparoscopic Nissen fundoplication in NI children is unclear.  It aimed to evaluate the role of scheduled UGI contrast studies to identify early postoperative complications following laparoscopic Nissen fundoplication in NI children. Data for laparoscopic Nissen fundoplications performed in NI children between January 2004 and June 2021 were reviewed. A total of 103 patients were included, with 60 of these being boys. Mean age at initial operation was 6.51 (0.11–18.41) years. Mean body weight was 16.22 (3.3–62.5) kg. Mean duration of follow up was 4.15 (0.01–16.65 years) years. Thirteen redo fundoplications (12.5%) were performed during the follow up period; eleven had one redo and two had 2 redos. Elective postoperative UGI contrast studies were performed in 94 patients (91%). Early postoperative UGI contrast studies were able to identify only one complication: an intrathoracal wrap herniation on postoperative day five, necessitating a reoperation on day six. The use of early UGI contrast imaging following pediatric laparoscopic Nissen fundoplication is not necessary as it does not identify a significant number of acute postoperative complications requiring re-intervention. 
  • 465
  • 23 Nov 2021
Topic Review
Elevated Serum Alpha-Fetoprotein Levels in Pregnant Women
The most common association related to alpha-fetoprotein (AFP) is fetal neural tube defect (NTD), and indeed, this is where the international career of this protein began. In times when ultrasonography was not yet technically advanced, the detection of high levels of AFP in maternal serum (MS-AFP) and amniotic fluid was the basis for suspecting neural tube defects. In cases where there was no confirmation of NTD, other causes were sought. It has been established that high titers of MS-AFP could originate in other defects or diseases, such as (1) increased proteinuria in severe fetal kidney diseases; (2) pathological overproduction in liver diseases; (3) penetration through the membranes of gastrointestinal organs exposed to amniotic fluid; (4) passage through the walls of skin vessels; and as a side effect of (5) hepatic hematopoiesis and increased transfer through the edematous placenta in fetal anemia. 
  • 234
  • 24 Jan 2024
Topic Review
Emerging Therapies for Advanced Cholangiocarcinoma
Cholangiocarcinoma (CCA) is a rare malignant tumor that develops from the epithelium of the bile ducts or peribiliary glands (PBGs). Although CCA is considered a rare tumor in Western countries, it represents 3% of all gastrointestinal malignant tumors worldwide and the second most common primary liver cancer
  • 497
  • 05 Nov 2021
Topic Review
Endocrine-Disrupting Chemicals and Nonalcoholic Fatty Liver Disease
Ecological theories suggest that environmental factors significantly influence obesity risk and related syndemic morbidities, including metabolically abnormal obesity associated with nonalcoholic fatty liver disease (MASLD). These factors encompass anthropogenic influences and endocrine-disrupting chemicals (EDCs), synergistically interacting to induce metabolic discrepancies, notably in early life, and disrupt metabolic processes in adulthood. 
  • 261
  • 19 Feb 2024
Topic Review
Endoscope Capsules
There are multiple benefits offered by capsule endoscopy (CE). First, the patients do not need sedation to undergo a CE analysis. The CE can analyze the entire GI tract from the esophagus, passing through the stomach, until the small intestine, which could not be properly analyzed through conventional endoscopy. The capsule has the size of a conventional vitamin capsule, and it can be easily swallowed, moving naturally through the GI tract until excretion. This fact indicates a painless procedure compared with the discomfort suffered by the long endoscopy sessions.
  • 429
  • 28 Nov 2023
Topic Review
Endoscopic and Surgical Management of Stricturing Crohn’s Disease
Crohn’s disease (CD) is a systemic disease, primarily affecting the gastro-intestinal tract, of which the etiology has not been clarified. Genetic and environmental factors are indicated to contribute to CD development. CD may affect any part of the digestive tract, whereas disease behavior may change over time and progress to fibrostenotic and penetrating disease. It is estimated that approximately 40% of CD patients will develop naïve symptomatic strictures (e.g., intestinal obstruction), whereas it is not uncommon for the development of anastomotic strictures. Diagnosis <40 years of age, need for steroids at diagnosis, small bowel involvement, and smoking has been associated with stricturing CD. Symptoms of stricturing CD may include nausea, vomiting, abdominal cramping, and abdominal flatulence, leading to decreased quality of life.
  • 319
  • 06 May 2022
Topic Review
Endoscopic Bariatric and Metabolic Therapies
Obesity is a chronic disease that is becoming increasingly more prevalent and is associated with many health problems, such as metabolic syndrome. The treatment options for obese patients include lifestyle modification, medications, endoscopic bariatric and metabolic therapies (EBMTs), and surgery. In particular, EBMTs have an excellent therapeutic effect and are less invasive than bariatric surgery.
  • 448
  • 10 Aug 2021
Topic Review
Endoscopic Diagnosis of Early Gastric Cancer
Endoscopy is mandatory to detect early gastric cancer (EGC). When considering the cost-effectiveness of the endoscopic screening of EGC, risk stratification by combining serum pepsinogen values and anti-H. pylori IgG antibody values is very promising. After the detection of suspicious lesions of EGC, a detailed observation using magnifying endoscopy with band-limited light is necessary, which reveals an irregular microsurface and/or an irregular microvascular pattern with demarcation lines in the case of cancerous lesions. Endocytoscopy enables us to make an in vivo histological diagnosis. 
  • 285
  • 11 Mar 2024
Topic Review
Endoscopic of the Upper Digestive Tract Management
The European Society for Gastrointestinal Endoscopy recommends immediate (<2 h, maximum 6 h after ingestion) therapeutic endoscopy for foreign bodies causing complete obstruction, sharp objects and batteries or magnets. Urgent endoscopy (<24 h) should also be performed for other esophageal foreign bodies without complete obstruction. Endoscopy of the upper digestive tract is very sensitive in detecting foreign bodies and has the advantage that therapeutic maneuvers can be performed. In addition, endoscopy may reveal pre-existing esophageal pathology leading to obstruction and any mucosal damage.
  • 640
  • 27 Mar 2023
Topic Review
Endoscopic Salvage of Gastrointestinal Anastomosis Leaks
Anastomotic leakage, which is defined as a defect in the integrity of a surgical join between two hollow viscera leading to communication between the intraluminal and extraluminal compartments, continues to be of high incidence and one of the most feared complications following gastrointestinal surgery, with a significant potential for a fatal outcome. Surgical options for management are limited and carry a high risk of morbidity and mortality; thus, surgeons are urged to look for alternative options which are minimally invasive, repeatable, non-operative, and do not require general anesthesia. 
  • 147
  • 07 Oct 2023
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