Individualized endoscopic management strategy for impacting jujube pits in the upper gastrointestinal tract: a 3-year single-center experience in northern China

Abstract Background Impaction of jujube pits in the upper gastrointestinal (GI) tract is a special clinical condition in the northern Chinese population. Endoscopic removal is the preferred therapy, but there is no consensus on the management strategies. We reported our individualized endoscopic strategies on the jujube pits impacted in the upper GI tract. Methods In this retrospective study, we included 191 patients (male: 57; female: 134) who presented to our hospital with ingestion of jujube pits between January 2015 and December 2017. Demographic information, times of hospital visiting, locations of jujube pits, endoscopic procedures, post-extraction endoscopic characteristics were analyzed. Management strategies including sufficient suction, repeated irrigation, jejunal nutrition and gastrointestinal decompression were given based on post-extraction endoscopic characteristics and impacted locations. Results Peak incidence was in the second quarter of each year (85/191 cases, 44.5%). Among the 191 cases, 169 (88.5%) showed pits impaction in the esophagus, 20 (10.5%) in the prepyloric region and 2 (1.0%) in the duodenal bulb. A total of 185 patients (96.9%) had pits removed with alligator jaw forceps, and 6 (3.1%) underwent suction removal with transparent caps placed over the end of the endoscope to prevent injury on removal of these pits with two sharp painted edges. Post-extraction endoscopic manifestations included mucosal erosion (26.7%), mucosa laceration (24.6%), ulceration with a white coating (18.9%) and penetrating trauma with pus cavity formation (29.8%). All patients received individualized endoscopic and subsequent management strategies and showed good outcomes. Conclusions Individualized endoscopic management for impacted jujube pits in the upper GI tract based on post-extraction endoscopic characteristics and impacted locations was safe, effective, and minimally invasive.

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Upper Gastrointestinal Langerhans Cell Histiocytosis: A Report of 2 Adult Cases and a Literature Review

International Journal of Surgical Pathology ◽

10.1177/1066896920964566 ◽

2020 ◽

pp. 106689692096456

Author(s):

Yui Matsuoka ◽

Yoshiki Iemura ◽

Masakazu Fujimoto ◽

Shinsuke Shibuya ◽

Atsushi Yamada ◽

...

Keyword(s):

Langerhans Cell Histiocytosis ◽

Mononuclear Cells ◽

Malignant Neoplasm ◽

Langerhans Cell ◽

Braf V600e ◽

Gi Tract ◽

Upper Gi ◽

Upper Gastrointestinal ◽

Upper Gi Tract

Langerhans cell histiocytosis (LCH) with primary involvement of the upper gastrointestinal (GI) tract is rare. We report 2 adult cases of localized LCH in the upper-GI tract, including the second reported adult case of esophageal LCH and review 11 previously reported cases. Case 1 involved the esophagus of a 61-year-old man; histiocytosis was detected when endoscopy was performed for an examination of epigastric pain. Case 2 involved the stomach of a 56-year-old woman wherein the lesion was detected during a follow-up endoscopy after Helicobacter pylori infection. Both biopsy specimens exhibited diffuse proliferation of mononuclear cells with nuclear convolution and a background of eosinophilic infiltrate. The cells were immunohistochemically positive for CD1a and langerin, and BRAF V600E mutation was detected in Case 2. Follow-up endoscopy for both cases revealed that the lesions disappeared without any treatment. It is important to avoid misdiagnosing LCH of the upper-GI tract as a malignant neoplasm.

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Faculty Opinions recommendation of Endoscopic management of foreign bodies in the upper-GI tract: experience with 1088 cases in China.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1048345.500255 ◽

2006 ◽

Author(s):

Pankaj Jay Pasricha

Keyword(s):

Foreign Bodies ◽

Endoscopic Management ◽

Gi Tract ◽

Upper Gi ◽

Upper Gi Tract

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Fecal Microbiota Transplantation Using Upper Gastrointestinal Tract for the Treatment of Refractory or Severe ComplicatedClostridium difficileInfection in Elderly Patients in Poor Medical Condition: The First Study in an Asian Country

Gastroenterology Research and Practice ◽

10.1155/2016/2687605 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 15

Author(s):

Tae-Geun Gweon ◽

Jinsu Kim ◽

Chul-Hyun Lim ◽

Jae Myung Park ◽

Dong-Gun Lee ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Fecal Microbiota Transplantation ◽

Medical Condition ◽

Performance Status ◽

Fecal Microbiota ◽

Gi Tract ◽

Upper Gi ◽

Low Performance ◽

Upper Gastrointestinal ◽

Upper Gi Tract

Background and Aims. Fecal microbiota transplantation (FMT) is a highly effective treatment option for refractoryClostridium difficileinfection (CDI). FMT may be challenging in patients with a low performance status, because of their poor medical condition. The aims of this study were to describe our experience treating patients in poor medical condition with refractory or severe complicated CDI using FMT via the upper GI tract route.Methods. This study was a retrospective review of seven elderly patients with refractory or severe complicated CDI and a poor medical condition who were treated with FMT through the upper GI tract route from May 2012 through August 2013. The outcomes studied included the cure rate of CDI and adverse events.Results. Of these seven patients who received FMT via the upper GI tract route, all patients were cured. During the 11-month follow-up period, CDI recurrence was observed in two patients; rescue FMT was performed in these patients, which led to a full cure. Vomiting was observed in two patients.Conclusions. FMT via the upper gastrointestinal tract route may be effective for the treatment of refractory or severe complicated CDI in patients with a low performance status. Physicians should be aware of adverse events, especially vomiting.

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Endoscopic management of foreign bodies in the upper-GI tract: experience with 1088 cases in China

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2006.01.059 ◽

2006 ◽

Vol 64 (4) ◽

pp. 485-492 ◽

Cited By ~ 137

Author(s):

Zhao-Shen Li ◽

Zhen-Xing Sun ◽

Duo-Wu Zou ◽

Guo-Ming Xu ◽

Ren-Pei Wu ◽

...

Keyword(s):

Foreign Bodies ◽

Endoscopic Management ◽

Gi Tract ◽

Upper Gi ◽

Upper Gi Tract

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Upper gastrointestinal tract involvement is more prevalent in Korean patients with pediatric Crohn’s disease than in European patients

Scientific Reports ◽

10.1038/s41598-020-75938-1 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Eun Sil Kim ◽

Yiyoung Kwon ◽

Yon Ho Choe ◽

Mi Jin Kim

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Disease Outcome ◽

Disease Phenotype ◽

Gi Tract ◽

Korean Patients ◽

Upper Gi ◽

Tract Involvement ◽

Upper Gastrointestinal ◽

Upper Gi Tract

Abstract In pediatric Crohn’s disease (CD) patients, it is important to define the disease phenotype at diagnosis for stratifying risk. In this retrospective study, we aimed to assess the disease phenotype compared to EUROKIDS registry and analyze disease outcome of pediatric CD patients according to upper gastrointestinal (GI) tract involvement. A total of 312 patients were included. The median age at diagnosis was 13.7 years and 232 patients (74.4%) were identified to have upper GI involvement at diagnosis. In Korean pediatric CD patients, there were significant differences in male predominance (72.8% vs. 59.2, p < 0.001), proportion of upper GI involvement (74.4% vs. 46.2%, p < 0.001), and perianal disease (62.1% vs. 8.2%, p < 0.001) compared to data in the EUROKIDS registry. Younger age (OR 2.594, p = 0.0139) and ileal involvement (OR 2.293, p = 0.0176) at diagnosis were associated with upper GI involvement. There were no significant differences in disease outcomes between patients with and without upper GI tract involvement. This study revealed that upper GI involvement is more prevalent in Korean patients with pediatric Crohn’s disease than in European patients, and the disease outcome did not appear to differ according to upper GI tract involvement.

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Endoscopic management and long-term follow-up of Dieulafoy's lesions in the upper GI tract

Gastrointestinal Endoscopy ◽

10.1067/mge.2002.122652 ◽

2002 ◽

Vol 55 (4) ◽

pp. 527-531 ◽

Cited By ~ 37

Author(s):

Panagiotis Kasapidis ◽

Philippos Georgopoulos ◽

Vassilios Delis ◽

Vassilios Balatsos ◽

Anastasios Konstantinidis ◽

...

Keyword(s):

Endoscopic Management ◽

Gi Tract ◽

Upper Gi ◽

Long Term Follow Up ◽

Upper Gi Tract

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Ageing-related bacterial features in different segments of the mice gastrointestinal tract

10.21203/rs.2.13401/v1 ◽

2019 ◽

Author(s):

Qi Zhou ◽

Liang Sun ◽

Linfang Li ◽

Huan Gong ◽

Ying Zhang ◽

...

Keyword(s):

Gastrointestinal Tract ◽

The Elderly ◽

Microbial Interactions ◽

Gi Tract ◽

Gastrointestinal Microbiota ◽

Upper Gi ◽

Β Diversity ◽

Metagenome Sequencing ◽

Upper Gastrointestinal ◽

Upper Gi Tract

Abstract Background: Ageing is associated with alternations of gastrointestinal (GI) microbiota according to metagenome sequencing. However, the most commonly used sequencing samples were from feces, therefore it remains unknown how the upper gastrointestinal microbiota changes with age and to what extent the fecal can represent the gastrointestinal microbiota. To investigate associations between the microbiota of whole GI tract and ageing, we compared microbial diversity and composition of six GI segments in different phenotypes with a mouse model. Results: Microbial α and β diversity were significantly different between the upper and lower GI tract. The jejunum and ileum samples had significantly lower phylogenetic diversity than large intestinal and stomach did (P < 0.01). About 22.9% core OTUs (n=80) were shared by the whole GI tract, and fecal represented significantly higher microbiota with content from large intestine than content form upper GI tract (82.7% vs. 65.2%, P <0.001). Sutterella, Aggregatibacter, Lactococcus, Lactobacillus and Streptococus were significantly enriched in the upper GI tract, while 14 anaerobes such as Ruminococcus were significantly enriched in the lower GI tract (P < 0.05). The elderly mice had the significant microbial dissimilarity (both in α and β-diversity) with the young- and middle-aged ones. These differences were dependent on GI segments; especially in the lower GI tract, more obvious variations were found. However, the age-associated change was smaller when it compared with the high-fat diet treated mice. Conclusion: The GI microbiota was gradually changed with age and the changes were affected by GI segments. The microbial interactions with host motivate future studies exploring the specified GI microbiota interventions of disease. Keywords: Healthy ageing, Gut microbiota, 16S rRNA sequencing, Gastrointestinal tract, mice

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