Body Of Stomach Research Articles

Features of the endoscopic picture of the upper gastrointestinal tract in Helicobacter pylori-infected patients of different ages

The aim. To evaluate the features of the endoscopic picture of the upper gastrointestinal tract (GI tract) in Helicobacter pylori-infected patients of different ages.Materials and methods. The study involved 126 adult patients aged 18 to 76 years (mean age 44.75±15.05 years) and 19 children aged 9 to 17 years (mean age 14.26±2.68 years) infected with H. pylori. All subjects underwent gastroscopy with an assessment of inflammatory and atrophic changes in the mucous membrane of the upper gastrointestinal tract, cardia insufficiency, sliding hernia of the esophageal orifice of the diaphragm (HE), duodenogastric reflux (DGR), as well as the presence of H. pylori (rapid urease test). Statistical data processing was carried out using the SPSS Statistics 27.0.1 program. Results. According to the endocropic data, in adult patients, signs of catarrhal esophagitis were detected in the esophagus: in 32.7% of cases, esophageal erosion was detected in 4.8% of the examined patients, HE occurred in 15.6%, and cardia insufficiency – in 23.3% of patients. When visualizing the gastric mucosa, its atrophy and hyperemia were observed in 8.8% and 77.9% of cases, respectively, erosive changes were detected in 2.8% of patients. Endoscopic signs of atrophy of the mucous membrane of the antrum of the stomach occurred in 34.0%, hyperemia – in 85.5%, and erosive changes – in 10.95% of the examined, DGR was observed in 8% of cases, pyloric deformity was detected in 13.5% of patients. Pathology of the mucous membrane of the duodenal bulb (duodenum) was noted in 89.9% of cases: signs of mucosal atrophy were detected in 2%, hyperemia in 79%, erosion in 21% of the examined, ulcerative defects of the mucosa were detected in 44% of patients: ulcer on the anterior wall – 47.8%, on the posterior wall – 25.4%, along the upper wall – 16.4%, ulcer of unspecified localization – 10.5%, two or more ulcers were detected in 9% of cases. According to the endoscopic data, the following changes in the esophagus were detected in children: 31.5% of patients showed signs of HE, cardia insufficiency and catarrhal esophagitis – in 57.9% and 15.8% of patients, respectively. When visualizing the mucous membrane of the stomach body, it was revealed: in 10.5% of cases – atrophic changes, in 63.2% of cases – signs of hyperemia. Hyperemia of the mucous membrane of the antrum of the stomach occurred in 100% of children. The frequency of detection of DGR was 42.1% of cases. Hyperemia of the mucous membrane of the BPC bulb was present in 84.2% of cases. No other changes were observed. A comparative analysis of the frequency of detection of gastrointestinal pathology in adults and children found that patients infected with H. pylori in childhood and adolescence are more likely to have cardia insufficiency (p<0.0001) and DHR (p<0.001). At the same time, the detection of erosions and ulcers of the mucous membrane of the BPC bulb was higher in patients over 18 years of age (p=0.023 and p<0.001, respectively).Conclusion. The age-related features of the endoscopic picture in patients infected with H. pylori are characterized by a predisposition of children and adolescents to impaired motility of the digestive tube, and adults to erosive and ulcerative changes, which may be a consequence of higher acid production. The fairly frequent detection of endoscopic signs of atrophy of the gastric mucosa dictates the need for histological examination in this category of patients using the OLGA system to establish the degree and stage of pathological changes, determine management tactics and follow-up of patients.

Spectrum of exploratory laparotomy for acute abdomen in a central Gujarat tertiary care centre

Background: Exploratory laparotomy is one of commonest emergency surgeries performed in the world. Despite technological advance imaging, the fundamental technique of exploratory laparotomy has remained unchanged over years. Studies quantifying the spectrum of laparotomy in central Gujarat are lacking. Methods: A retrospective study of 249 patients of emergency exploratory laparotomy for acute abdomen in SSG Hospital Baroda from May 2022 to May 2024 was done and data involving clinical presentation, imaging, operative findings and post- operative course were studied and analysed. The cases were divided into gastro-intestinal perforation, gastro-intestinal obstruction and miscellaneous cause. Results: The most common cause of exploratory laparotomy in study was perforation peritonitis including 59 ileal, 16 jejunal, 49 pre-pyloric, 29 duodenal, 1 body of stomach, 17 appendicular and 8 colon. With post op major complications like burst-11%, leak-5%, pneumonia-5%, multi-organ failure-6.5% and ileus 5%, wound infection 18%. The overall mortality was 15%. Out of 58 cases of laparotomy for obstruction including adhesions (29.3%), obstructed inguinal hernia (12%), tuberculosis (32%), malignancy (13.8%), internal hernia (12.6%). The miscellaneous causes were ruptured liver abscess (9), rupture ectopic pregnancy (2), twisted ovarian tumour (1). Conclusions: Acute abdomen remains a significant surgical problem. Peptic perforation remains a common cause of acute abdomen with high morbidity and mortality, despite improves medical management, though there is a declining trend in incidence, tuberculosis remains an important cause.

ThP3.12 - Assessing Photo-documentation Compliance in Oesophago-Gastroduodenoscopy: A Review of Adherence to BSG and AUGIS Recommendations

Abstract Aim In 2017, the British Gastroenterology Society (BSG) and the Association of Upper GI Surgeons of Great Britain and Ireland (ASGBI) issued a position statement outlining specific quality parameters for oesophago-gastroduodenoscopy (OGD), including photo-documentation of eight specified anatomical sites. This audit assesses the appropriate utilization of photo-documentation for diagnostic OGD. Methods A retrospective analysis of diagnostic OGD preformed in a single centre. General surgeons, gastroenterologist and nurse endoscopists performed OGDs. Patient with incomplete OGD or those carried out for therapeutic purposes were excluded. OGD report included photo-documentation was analysed. Results 250 OGD were included; 54.8% were male and median age was 61 years. Indications for OGD were: 28% for nausea/vomiting, 26% for dysphagia, 22.4% for upper GI bleed, 12.4% for abdominal pain, 12% for anaemia, 11.2% for weight loss and 8.4% for dyspepsia. 62% of OGDs had photo-documentation: 9.6% upper oesophagus, 45.2% gastro-oesophageal junction, 36.8% fundus in retroflexion, 26% body of stomach, 8% incisura in retroflexion, 30.8% antrum, 17.2% duodenal bulb and 36% distal duodenum. Overall, 1.2% of OGDs had all eight anatomical sites photo-documented, all by the same endoscopist. Conclusion Robust photo-documentation plays a crucial role in ensuring both accurate clinical assessments and meeting medico-legal requirements. Our audit indicates that the current level of photo-documentation in OGD is less than optimal. Enhancing endoscopist education and raising awareness about recommended practices may lead to improved results. Further research is imperative to explore the underlying factors contributing to suboptimal photo-documentation, fostering a deeper understanding and facilitating targeted interventions for improvement.

Prevalence of cagA, cagM, vacA and oipA genes in isolates of Helicobacter pylori obtained from hospital patients in Northeast Brazil.

Helicobacter pylori is a major cause of gastrointestinal disorders such as chronic gastritis, peptic ulcers, mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric cancer. It is estimated that around half of the world's population is infected with this pathogen, with underdeveloped countries reporting the highest frequencies. The genes cagA, cagM, vacA, and oipA are some of the most important virulence factors of H. pylori; however, there are no recent studies from Recife-PE demonstrating their frequency, and their relationship with severe gastric modifications. This work aims to use qualitative PCR to detect the virulence genes cagA, cagM, vacA, and oipA in H. pylori isolates obtained from patients in a public hospital in Recife (PE). We collected samples from the stomach's body and antrum of 147 patients, from which 71 (48%) tested positive for H. pylori. Among positive samples, the most frequently infected gender was female (44/71, 62%), and the most frequently infected age group was those above the age of 46 (31/71, 44%). Histological examination of H. pylori-positive samples revealed alterations other than chronic gastritis, including metaplasia and atrophy. The frequency of cagA, cagM, and oipA genes were identified in 84%, 56%, and 69% of the samples tested, respectively, as well as the vacA-s1m1 allelic combination (77%). However, there was no statistically significant variation in the occurrence of these genes, therefore they cannot be considered unique markers of severity in our setting. New research with larger samples and investigations of other genetic markers can aid uncover local risk factors and lead to a better understanding of H. pylori's pathogenesis.

Autoimmune gastritis. Features of diagnosis and clinical course in children

Introduction. Autoimmune atrophic gastritis (AAG) is an immune-mediated disease characterized by inflammation and progressive atrophy of the mucous membrane of the fundus and body of the stomach, while the antrum remains intact for the autoimmune process. The pathogenesis of AAG is determined by the development of atrophic, hyperplastic, and metaplastic changes in the mucous membrane of the stomach body, which is a predictor of the development of neuroendocrine tumors type I. However, among pediatricians and gastroenterologists, there is still no proper alertness regarding the diagnosis of AAG. Clinical examples of complex diagnosis of AAG in children using clinical laboratory, endoscopic, and pathohistological methods are presented. To make a diagnosis, attention should be paid to concomitant autoimmune diseases, characteristic endoscopic and pathomorphological signs, as well as clinical and laboratory changes. The analysis of these changes increases the likelihood of a correct diagnosis of AAG, which is an important aspect of cancer prevention.

Intragastric pressure and peristalsis analysis of the sleeve gastric tube after laparoscopic sleeve gastrectomy

IntroductionLaparoscopic sleeve gastrectomy (LSG) is a procedure that is being increasingly recommended. However, LSG can worsen gastroesophageal reflux disease (GERD) and cause vomiting, and consequently impact the quality of life (QOL) of patients. Abnormal motility of the sleeve gastric tube has been linked to the onset of GERD and vomiting. Hence, this study investigated the peristalsis of the sleeve gastric tube after LSG and its relationship with gastroesophageal reflux. There are only a few reports on the peristalsis of the sleeve gastric tube after LSG. MethodsWe measured the motility function of the sleeve gastric tube using high-resolution manometry (HRM) within 2–4 weeks after LSG. The manometry catheter was positioned in the antrum using fluoroscopy. ResultsThis analysis included 18 patients. Postoperative HRM measurement of the sleeve gastric tube was characterized by the absence of gastric body peristalsis in at least 90% of swallows and contractions of the antrum. Furthermore, reverse peristalsis was observed from the pyloric antrum toward the stomach body although the frequency was low. ConclusionsLSG was associated with characteristic of pressure and peristalsis in sleeve gastric tube. HRM was able to detect and visualize intragastric pressure and peristalsis of the sleeve gastric tube.

Helicobacter pylori-Associated Extranodal Marginal Zone Lymphoma of Mucosa-Associated Tissue in Children: A Multicenter Case Series.

Data regarding Helicobacter pylori (H. pylori)-associated mucosa-associated lymphoid tissue (MALT) lymphoma in children are lacking. We aimed to characterize the diagnosis, management, and outcome of H. pylori-associated MALT lymphoma in pediatric patients. A retrospective multicenter case series of the pediatric patients with H. pylori-associated MALT lymphoma who were diagnosed during 2010-2022. Five children, of them three females, were identified. The mean age at diagnosis was 14.6 ± 2.4 years. The clinical presentation included abdominal pain (5/5), nausea (3/5), weight loss, night sweats, recurrent fever (1/5), and iron deficiency anemia (2/5). Endoscopic findings in both the stomach antrum and body included a fragile and hyperemic mucosa, large ulcers, extensive nodularity, and exudate. All the biopsies from the gastric mucosa were consistent with MALT lymphoma, and positive for H. pylori (by Giemsa stain). All the patients received triple therapy (amoxicillin, nitroimidazole, or a macrolide, and a proton pump inhibitor, for 14 days), and achieved H. pylori eradication. All had complete resolution of histological findings at the last follow-up. In one patient, the histology of MALT lymphoma persisted 12 months after H. pylori eradication, and only the 18-month-biopsy was free of residual disease. In this series of pediatric MALT lymphoma, complete resolution of disease occurred in all the patients, yet histological remission was delayed in one. This supports the importance of endoscopic follow-up.

Digestive tract morphology and argyrophil cell distribution of three sympatric lizard species

The digestive tract plays a crucial role in an organism’s health. Here, the digestive tract morphology and argyrophil cell distribution of three sympatric lizard species, Teratoscincus roborowskii, Phrynocephalus axillaris and Eremias roborowskii, were studied. Our results show that T. roborowskii’s snout–vent length (SVL) and digestive tract length (DTL) were significantly longer than those of P. axillaris and E. roborowskii. P. axillaris’ relative intestine length was 1.25, which was significantly longer than those of the other two species. The three lizard species’ digestive tract structures were generally similar, whereas their histologic characteristics exhibited significant differences. Particularly, T. roborowskii’s and P. axillaris’ esophagus mucosa was pseudostratified ciliated columnar epithelium, whereas simple columnar epithelium was observed in E. roborowskii, which also had fewer mucosal folds than the other two species. In all three lizard species, the small intestines’ mucosal lining consisted of simple columnar epithelium with many goblet cells; the largest quantity of villi was found in T. roborowskii. Moreover, T. roborowskii’s mucous membrane (MM) and tunica muscularis (TM) were obviously thicker than those of the other two species. However, the argyrophil cells’ distribution densities of the three species were remarkably different; such differences were highest in the cardia of T. roborowskii and E. roborowskii, but P. axillaris was observed to have more argyrophil cells in its stomach body. Our results indicated that the three lizards’ different histomorphologies might be due to limited food resources, availability of a single food type in the Turpan Basin’s extremely arid and hot environment, as well as T. roborowskii’s special frugivorous behavior. Morphological studies of these lizards are necessary to understand their digestive systems’ structure and operation, as well as to facilitate physiological studies of adaptions to extreme desert habitats.

Варианты патогенетического лечения аспирининдуцированных гастроэнтеропатий у лиц с хронической ишемической болезнью сердца

Aim: Evaluation of Rebamipide treatment efficiency for aspirin-induced gastroduodenopathy in the patients with stable coronary heart disease (CHD). Design: Randomised controlled study. Materials and methods: In the course of the conducted research 340 CHD patients receiving long-term acetylsalicylic acid therapy in cardioprotective doses were studied. All the patients received complete clinical laboratory examination. For CHD verification there was applied selective method of coronary angiography. Gastroduodenopathy was verified by esophagogastroduodenoscopy. In both cases frequency and structure of the aforesaid events were assessed. For aspirin-induced gastroduodenopathy treatment there were applied either endogenic prostaglandin stimulant Rebamipide in combination with proton pump inhibitor (PPI) Pantoprazole (study group, n = 26) or Pantoprazole only (control group, n = 25). Prior to initiating therapy and on completion all the patients were taken blood samples for evaluation of prostaglandin E2 (PGE2) and proinflammatory cytokines (interleukine-1β Il-1β and interleukine-6 Il-6, TNF-α) levels in blood serum for verification of pathogenetic mechanisms in erosive or ulcer-bearing areas developing in gastrointestinal mucosa in association with long-term aspirin therapy. Соntrol group consisted of 26 CHD patients with no evidence of gastroduodenopathy. Statistical processing of the received data was conducted with the software program “Statistics 10.0”. Results. Aspirin-induced gastroduodenopathy was identified in 51 out of 340 (15,0%) cases. According to esophagogastroduodenoscopy data, erosions of the body and antrum of stomach were prevailing (43,1%) over all the erosive damages. CHD patients before the gastroduodenopathy treatment had significantly lower PGE2 levels in comparison with control group (p < 0,01), while proinflammatory cytokines indices were higher (p < 0,001). On the treatment completion 19 patients in the control group did not show endoscopic evidence of gastroduodenopathy, the laboratory findings tended to normalization. Gastric mucosa condition in the study group stabilized in all the cases, which was confirmed by statistically significant PGE2 level positive alterations (p < 0,001) and also cytokine profile alterations (TNF-α: p < 0,001; Il-1β and Il-6: p < 0,01). Conclusion. The presented study demonstrates clinical features of aspirin-induced gastroduodenopathy development in the CHD patients and proposes possible ways of correction. Key words: aspirin-induced gastroduodenopathy, acetylsalicylic acid, prostaglandin E2, proinflammatory cytokines, rebamipide.

Phytochemicals: a new arsenal in drug discovery

In ancient times traditional herbs were used to treat different diseases such as stomach discomfort, toothache, body pain and inflammation, diarrhea, malaria, typhoid, diabetes, and so on. Medicinally important plants are recognized to have chemicals or phytochemicals that could be useful for illness treatment or medication manufacture. These compounds occur naturally in plant parts (leaves, stems, barks, and roots) and are referred to as secondary metabolites because, like primary metabolites, they are synthesized to protect the plant rather than for growth. Fortunately for humans, the majority of these secondary metabolites have therapeutic properties that are useful against a variety of diseases and health problems. Resistance to antibiotics is one of the world's most critical health challenges, with numerous infections rapidly gaining resistance to conventional antimicrobials. There is currently no viable therapeutic agent with the ability to reverse antimicrobial resistance, and several leading laboratories are working hard to find new antimicrobials. Plant-based chemical compounds have received comparatively little attention in the context of antimicrobial medication development. Natural chemicals have piqued the interest of drug development scientists because of their structural diversity, chemical novelty, abundance, and bioactivity. Cancer is currently a major problem. Despite the numerous interventions available, a huge number of patients die each year as a result of cancer disorders. The rising research direction in healthcare pharmacy is the development of an effective and side-effect-free anticancer medication. Chemical entities found in plants have proven to be particularly promising in this area. Bioactive phytochemicals are preferred because they act differentially on cancer cells while leaving normal cells alone. This review provides an overview of the utility of medicinal plants as well as secondary metabolites of plants as drug sources, the drug discovery process, the efficacy and safety of phytochemicals, current applications, developments in screening technologies, challenges, and future directions.

Persistent upper gastrointestinal symptoms after Helicobacter pylori eradication: malignant lymphoma following "chicken skin-like" gastritis.

A 37-year-old patient presented to our hospital for upper endoscopy with upper abdominal pain for 10 days. The gastroscopy showed food retention, a large ulcer from the corner of the stomach to the stomach body was seen, the bottom was obviously depressed, the surface was covered by white moss, and the edge of the ulcer presented as a "auricular" sign (Ear-shape appearance). Pathology showed malignant lymphoma. One and a half years prior, the patient underwent a gastroscopy at our hospital. At that time, the gastroscopy showed a large number of nodular protrusions in the gastric antrum, gastric angle, and some parts of the gastric body, presenting a "chicken skin like" change. At the same time, a superficial ulcer lesion was visible in the gastric angle. Pathology suggested gastritis and a small amount of necrotic tissue, as well as proliferation of lymphoid follicles. After receiving the treatment to eradicate Helicobacter pylori (HP), the patient's symptoms significantly improved and no further follow-up was conducted.

A Novel Tactile Sensing System Utilizing Magnetorheological Structures for Dynamic Contraction and Relaxation Motions.

It is well known that the rheological properties of magnetorheological (MR) material change under a magnetic field. So far, most works on MR materials have been oriented toward actuating characteristics instead of sensing functions. In this work, to realize dynamic tactile motion, a spherical MR structure was designed as a sensor, incorporating a magnetic circuit core to provide maximum dynamic motion. After manufacturing a prototype (sample), a sinusoidal magnetic field of varying exciting frequency and magnitude was applied to the sample, and the dynamic contraction and relaxation motion depending on the exciting magnetic field was observed. Among the test results, when 10% deformation occurred, the instantaneous force generated was from 2.8 N to 8.8 N, and the force when relaxed was from 1.2 N to 3.5 N. It is also shown that the repulsive force within this range can be implemented using an acceptable input current. The special tactile sensing structure proposed in this work can be used as a sensor to measure the field-dependent viscoelastic properties of human tissues such as stomach, liver, and overall body. In addition, it could be usefully applied to robot surgery, because it can mimic the dynamic motions of various human organs under various surgical conditions.

Primary gastric mucormycosis

Primary gastric mucormycosis is a rare but potentially lethal fungal infection due to the invasion of Mucorales into the gastric mucosa. It may result in high mortality due to increased risk of complications in immunocompromised patients. Common predisposing risk factors to develop gastric mucormycosis are prolonged uncontrolled diabetes mellitus, solid organ, or stem cell transplantation, underlying hematologic malignancy, and major trauma. Abdominal pain, hematemesis, and melena are common presenting symptoms. Diagnosis of gastric mucormycosis can be overlooked due to the rarity of the disease. A high index of suspicion is required for early diagnosis and management of the disease, particularly in immunocompromised patients. Radiological imaging findings are nonspecific to establish the diagnosis, and gastric biopsy is essential for histological confirmation of mucormycosis. Prompt treatment with antifungal therapy is the mainstay of treatment with surgical resection reserved in cases of extensive disease burden or clinical deterioration. We presented a case of acute gastric mucormycosis involving the body of stomach in a patient with no comorbidity, however he had post COVID status, admitted with hematemesis. Complete resolution of lesion was noted with medical treatment with intravenous amphotericin B.

Glanzmann's Thrombasthenia with Involuntary Upper and Lower GI Bleeding: A Case Report

A rarely seen bleeding illness called Glanzmann's thrombasthenia (GT) is inherited via the autosomal recessive gene. Platelet membrane glycoprotein IIb/IIIa (integrin aIIbb3) structural abnormalities and malfunction play a major role in the development of GT. The most prevalent signs of GT are various types of bleeding, including menorrhagia in females, recurrent nasal bleeding, mucocutaneous bleeding, and continuous bleeding after injury or surgery. Some patients may not survive after undergoing such a hemorrhage. It is unusual for GT to experience spontaneous upper and lower gastrointestinal hemorrhages. In this case study, a young boy with accidental bleeding in vomitus and fresh blood in his stool was hospitalized. His primary GT is an uncommon autosomal recessive genetic condition characterized by dysfunctional platelet aggregation symptoms that were sporadic and recurring chronic fresh blood in his stool. Blood dripped from the stomach body wall during the gastroscopy. However, except for petechiae no visible lesions were discovered, like erosion or ulceration. Further investigations revealed that the patient's BT and CT were prolonged and platelet aggregation was poor. After receiving aggressive treatment, the patient showed clinical improvement and was eventually diagnosed with GT.

Clinical and Morphological Features of Dysplasia and Early Gastric Cancer in the Patients with Autoimmune Gastritis

Аim: to analyze a series of cases of dysplasia and early gastric cancer developed in patients with autoimmune gastritis (AIG), and to identify their clinical and morphological features.Materials and methods. The study included six cases of detection of early gastric cancer on the background of AIG. Four out of six patients underwent endoscopic treatment, and in three out of six cases patients underwent endoscopic mucosectomy with dissection in the submucosal layer. One patient underwent endoscopic surgery in 2017, he continues annual dynamic follow-up without signs of tumour recurrence. A female patient with type 1 neuroendocrine tumour and mild dysplasia is awaiting treatment.Results. In five out of six patients with AIG, the localization of lesions prevailed in the stomach body, while all detected tumours were early ones, and according to the immunophenotype — of a gastric type. The presented cases of tumours were not accompanied by hyperplasia of neuroendocrine cells directly in the area of the tumour itself, but only in the surrounding gastric mucosa. Additionally, several cases of early gastrointestinal stromal tumours were found, which were characterized by low proliferative activity and had small sizes.Conclusion. The predominance of pseudopyloric metaplasia in the surrounding mucosa allows us to consider pseudopyloric metaplasia as a potentially significant change in the gastric mucosa of patients with AIG that may precede the development of gastric cancer.

Robotically assisted total gastrectomy for lymphadenopathy after long-term follow-up for multiple type 1 gastric neuroendocrine tumor (NET): a case report

BackgroundType 1 gastric neuroendrine tumor (NET) is usually associated with chronic atrophic gastritis and forms multiple lesions. While most cases of type 1 gastric NET are generally slowly growing, some develop regional lymph node metastases even after long-term dormancy.Case presentationA 73-year-old male patient with a 32-year history of multiple gastric NET was being followed-up at the study center after endoscopic submucosal dissection (ESD) of a large gastric NET. A blood examination revealed high serum gastrin (> 3000 pg/ml). An endoscopic examination found atrophic mucosa and multiple, elevated lesions in the upper to lower stomach body. Computed tomography (CT) revealed regional lymphadenopathy in the greater omentum along the gastroepiploic artery. Robotically assisted total gastrectomy was performed with D2 lymphadenectomy and Roux-en-Y reconstruction. Pathological analysis revealed a large number of gastric NET (grade 1) with a maximum size of 4.5 mm invading the submucosal layer. A single lymph node metastasis was also detected pathologically at station #4d. The postoperative course was uneventful, and serum gastrin normalized postoperatively. At postoperative year 3, the patient has been doing well without any recurrences.ConclusionsThe present case of multiple gastric NET with a single regional lymph node metastasis at year 32 of follow-up was successfully treated with a robotically assisted total gastrectomy.

Endoscopic resection of gastric calcifying fibrous tumor: An incidental finding

Calcifying fibrous tumor (CFT) is benign mesenchymal lesion. CFTs of the GI tract are quite rare with less than 60 cases of gastric CFTs reported in the English literature. In a healthy 49 old female, routine Endoscopic ultrasonography (EUS) revealed an internally isoechoic, homogeneous 12mm lesion mainly within the submucosa in the distal body of stomach with no significant past history. An endoscopic submucosal dissection (ESD) was done to rule out malignancy. The histopathological examination showed a hypocellular lesion with few spindle cells interspersed in a hyalinized, collagenous matrix with occasional lymphoplasmacytic cells. Foci of psammomatous, dystrophic calcification were noted. Immunohistochemical examination revealed tumor cells positive for vimentin and negative for CD34, CD117, DOG1, desmin, SMA and S100. Based on histopathological and IHC findings, a diagnosis of gastric calcifying fibrous tumour was made. Only a handful of CFT cases resected by endoscopic submucosal dissection has been reported in the literature. So herein we report a rare case of endoscopically resected gastric calcifying fibrous tumor.

Easier way of managing gastric gastrointestinal stromal tumor located at unusual site: a case report

Intraluminal gastric gastrointestinal stromal tumors (GISTs) located at the posterior wall and near the gastroesophageal (GE) junction represent a surgical challenge. We present a easier laparoscopic assisted mini laparotomy approach for resection of gastric GISTs of such location. A 42 years old female presented with history of Malena and anemia. Endoscopic and contrast enhaced computerised tomography (CECT) scan findings were suggestive of GIST arising from posterior wall along lesser curvature in proximal body of stomach. We planned her for surgical resection of tumor. During laparoscopy, posterior wall stomach was completely mobilised after dividing gastrocolic and phrenogastric ligaments. Due to unfavourable location of tumor in posterior wall and proximity to GE junction, accessibility for negative resection margin was difficult, so we did mini laparotomy (approx 5 cm midline incision) and already mobilised stomach is delivered out, wedge resection of tumor done after assuring resection margin with direct palpation. GISTs of the posterior wall and in close proximity to the GE junction can be safely resected with laparoscopic assistance using such an approach. This technique is useful alternative in unavailability of simultaneous laparoscopy with endoscopy as required in laparoscopic and endoscopic cooperative surgery in such locations of tumor.

Gastric Neoplasm – A Diagnostic Puzzle

Introduction: Paragangliomas are non-epithelial neuroendocrine tumors originating from neural crest derived paraganglion cells situated in the region of the autonomic nervous system ganglia and accompanying nerves. Very few cases of primary gastric paraganglioma have been reported in the literature till date. We report a rare case of primary gastric paraganglioma. Case Report: A 38 year old woman presented with history of melena and dyspepsia. Physical examination revealed mild tenderness in the right hypochondrium, and she was diagnosed to have gall stone disease. However, upper gastrointestinal endoscopy and contrast enhanced computed tomography whole abdomen revealed presence of a small elevated intraluminal lesion at the body of stomach along greater curvature and clinically diagnosed as gastrointestinal stromal tumor(GIST). Endoscopic biopsy report revealed a diagnosis of submucosal Brunner’s gland hamartoma. Laparoscopic cholecystectomy and laparoscopy assisted wedge resection of the stomach mass was done and the specimens were sent for histopathological examination. The stomach mass was diagnosed as paraganglioma which was confirmed by immunohistochemistry. Conclusion: Primary gastric paraganglioma is a very rare tumor. They are more difficult to diagnose if they are non-functional. Complete surgical excision is the first line treatment that can be performed with open surgical resection or laparoscopic technique.

The Effect of “Seiza” Sitting Position During Dzikr After Moslem Prayer on Stomach Circumference Changes: A Case Report

Introduction.The Japanese floor-sitting Seiza is reflected of femoral artery pinched, which improved of tissues oxygenation and circulation. It might play role on body metabolism, also the nerves system.Methods: Study was conducted on a 20-year-old obese man performed routinely dzikr with Seiza sitting, so the time duration counted. Stomach circumference and body weight was monitoring twice weekly until 1 month.Results: The stomach circumference measurements of 114 cm observed improvement, as at week 1 (1.75%), week 2 (0.88%), week 3 (63%), and week 4 (3.51%) underwent 316 to 334 seconds weekly of Seiza sittings. A 100,4 kg of body weight showed gradually improvement: 0.55%, 0.35%, 0.25%, and 1.89% in each weeks.Discussion: The Seiza sitting might be relate to St36 Meridian points. It stimulated of parasympathetic system, digest and absorption, aliementary glands activated, also fat metabolism.Conclusions: The Seiza sitting during dzikr after prayer might improve of body metabolism.International Journal of Human and Health Sciences Vol. 07 No. 02 April’23 Page: 202-206