Abstract:
GOAL:To prospectively assess the utility of multidetector row computed tomography angiography (MDCTA) in the diagnosis of active gastrointestinal bleeding (GIB). BACKGROUND:MDCTA is a relatively recent advance in CT scanning technology enabling excellent vascular visualization and detection of various vascular abnormalities. However, there is no prospective study with a large population evaluating the role of MDCTA in the diagnosis of active GIB. STUDY:From January 2006 to January 2011, 113 consecutive patients with clinical signs of active GIB underwent MDCTA (16-slice, 64-slice, or dual-source). The criteria for positive CT findings included active extravasation of contrast material within bowel lumen, abnormal bowel mucosal enhancement, vascular malformation, abnormally enhancing polyp or diverticulum, or tumor. Two radiologists reviewed the images and assessed CT findings in consensus. The standards of reference included digital subtraction angiography, endoscopy, surgery, or final pathology reports. Sensitivity, specificity, positive and negative predictive values, and accuracy of MDCTA for detection of active GIB were evaluated. RESULTS:Positive CT findings for active GIB were identified in 80 of 113 patients (70.8%), all of which were confirmed by 1 or more reference standard. Negative MDCTA results were obtained in 33 patients (29.2%). Of these, 27 patients did not require any further intervention and were discharged without incident. The overall sensitivity, specificity, positive and negative predictive values, and accuracy of MDCTA was 86.0%, 100%, 100%, 60.6%, and 88.5%, respectively. CONCLUSIONS:MDCTA is an accurate first-line screening method for detection and localization of GIB and can guide triage in patients with active GIB.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Sun H,Jin Z,Li X,Qian J,Yu J,Zhu F,Zhu Hdoi
10.1097/MCG.0b013e31823337eesubject
Has Abstractpub_date
2012-01-01 00:00:00pages
31-41issue
1eissn
0192-0790issn
1539-2031journal_volume
46pub_type
杂志文章abstract:GOALS:To determine the long-term efficacy of endoluminal gastroplication (ELGP) and the most effective plication configuration. BACKGROUND:Endoluminal gastroplication is an intriguing therapy for gastroesophageal reflux disease. We conducted a retrospective review of a prospective experience of patient cohorts compari...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/01.mcg.0000180632.99936.6f
更新日期:2005-11-01 00:00:00
abstract::The prevalence of hepatitis C virus (HCV)-RNA positivity among hemodialysis patients varies between 10 and 70%. Few previous surveys revealed high frequency of seroconversion of HCV-RNA-negative patients over the years of hemodialysis. Only few studies reported HCV genotype variability. We evaluated all 65 patients on...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199901000-00005
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Hypoxic hepatitis (HH) occurring after gastrointestinal bleeding in cirrhotic patients has been scarcely studied and is reported as a rare occurrence carrying a severe prognosis. The management of bleeding from esophageal varices (BEV) and similarly the prognosis has improved in the last decades. GOALS:To e...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318254e9d4
更新日期:2012-08-01 00:00:00
abstract::Although many aspects of percutaneous endoscopic gastrostomy (PEG) have been addressed in the literature, attention to psychologic and social outcomes of PEG has been limited. Our goal was to assess a range of physical, psychologic, and social outcomes related to PEG feeding. This study is a follow-up survey of patien...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200101000-00012
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Hypertriglyceridemia has been positively associated with the risk of acute pancreatitis (AP), but whether increased triglyceride (TG) levels are associated with the severity of AP remains unknown. To this, a meta-analysis was conducted to assess the effect of elevated serum TG on the prognosis of AP. METHOD...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MCG.0000000000000846
更新日期:2017-08-01 00:00:00
abstract::We have seen three patients with acute ulcerative colitis after hydrogen peroxide enemas. The colitis is probably the result of the explosive entrance of gas into the loose connective tissues of the mucosa and submucosa of the rectum and sigmoid. Fortunately, it is transitory in nature, but it should be distinguished ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198103000-00008
更新日期:1981-03-01 00:00:00
abstract::Insulin resistance is an integral part of the underlying pathophysiology in most patients with nonalcoholic fatty liver disease (NAFLD). Insulin-sensitizing agents are therefore likely to be of key importance in the treatment of this disorder, especially in the histologically more severe form known as nonalcoholic ste...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/01.mcg.0000168647.71411.48
更新日期:2006-03-01 00:00:00
abstract::Two cases of multiple lymphomatous polyposis (MLP) are presented, involving different segments of the gastrointestinal tract. Both cases display the characteristic clinical and pathologic features of MLP. In addition, we were able to document, for the first time, the endoscopic ultrasonographic findings in this diseas...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200202000-00010
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:Guidelines recommend upper endoscopic screening of cirrhotic patients for gastroesophageal varices. Cirrhosis is not always distinguishable from chronic hepatitis. GOALS:To identify low-risk patients who can be spared upper endoscopy irrespective of a diagnosis of cirrhosis. STUDY:We evaluated 13 nonendosc...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318157464b
更新日期:2009-01-01 00:00:00
abstract::Progressive systemic sclerosis (PSS) causes smooth muscle atrophy and fibrosis of the distal two-thirds of the esophagus. Motility studies show reduced-amplitude or absent peristaltic contractions in this region and normal or decreased lower esophageal sphincter pressure. Patients complain of dysphagia, heartburn, and...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/01.mcg.0000225549.19127.90
更新日期:2006-10-01 00:00:00
abstract:INTRODUCTION:Long-term gastric acid suppression has been suggested as a means to prevent complications of reflux esophagitis. We report on the 20-year follow-up of 2,306 patients with at least two endoscopic examinations who were taking no antisecretory medication before baseline endoscopy and whose long-term treatment...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200605000-00007
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND AND AIM:Voice-related complaints are the most common extraesophageal manifestation of gastroesophageal reflux disease (GERD). The aim of this study was to compare objectively measured voice parameters in normal subjects and patients with GERD and to assess the impact of antireflux surgery on these parameters...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e31822f386e
更新日期:2012-02-01 00:00:00
abstract:GOALS:We investigated the prognosis of Crohn's disease (CD) in Korean patients with jejunal involvement. BACKGROUND:Although jejunal involvement is considered a poor prognostic factor of CD in whites, it has never been validated in Asian populations. METHODS:We retrospectively reviewed the medical records of 1403 Kor...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3182705f9e
更新日期:2013-05-01 00:00:00
abstract::Thirty-five consecutive patients with acute hematochezia, negative gastric aspirates, and negative sigmoidoscopy underwent urgent colonoscopy after Golytely purgation. Mucosal visualization was excellent. Colonic bleeding lesions were identified in 24 of 35 patients, and hemorrhage originating proximal to the ileoceal...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198602000-00010
更新日期:1986-02-01 00:00:00
abstract::The single technological advancement that Bravo pH monitoring offers over conventional pH monitoring is the elimination of the transnasal catheter. This was not a trivial advance in terms of technologic achievement. Development of a delivery system that could temporarily place a wireless capsule on the esophageal muco...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e31815bb602
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:There was some ambiguity in the recent guidelines on the use of capsule endoscopy (CE) in cases of iron deficiency anemia (IDA). GOAL:We aimed to examine the yield of CE in diagnosing the cause of IDA and to define clinical parameters that predict higher diagnostic yields. MATERIALS AND METHODS:A total of ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001255
更新日期:2020-05-01 00:00:00
abstract::Gastroesophageal reflux disease, especially when refractory to standard therapy, remains a significant clinical problem. Although symptom pathogenesis in erosive reflux disease is relatively easy to understand, it is less clear how exposure of the macroscopically normal mucosa in nonerosive reflux disease (NERD) is ab...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e318299f181
更新日期:2014-01-01 00:00:00
abstract::We report four new cases of oral manifestation in Crohn's disease (CD) and evaluate 75 reported cases for morphology and site of oral and intestinal manifestations of CD, clinical manifestation, and treatment. Oral CD was the presenting symptom in 43 of 72 (60%) patients and relapsed in 34 of 60 (57%). Median age at p...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199102000-00008
更新日期:1991-02-01 00:00:00
abstract::The practice of gastroenterology is undergoing sweeping changes that demand improvements in efficiency and effectiveness within the practice and ambulatory endoscopy centers. This article discusses core principles of practice and endoscopic ambulatory surgery center function and management that lead to the improvement...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318046ef80
更新日期:2007-04-01 00:00:00
abstract::The pathogenesis of peptic ulcer disease is multifactorial, including the effects of Helicobacter pylori, gastric acid, pepsin, gastroduodenal motility, smoking and nicotine, and the complex interaction of an array of other so-called aggressive and protective factors. Since the discovery and acceptance of H. pylori as...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199700001-00003
更新日期:1997-01-01 00:00:00
abstract::Dysphagia frequently follows stroke, but often resolves quickly. Percutaneous endoscopic gastrostomy (PEG) or other feeding tubes are placed to improve nutrition and hydration, and reduce the risk of aspiration pneumonitis. We evaluated the impact of modified barium swallow in determining PEG placements and the influe...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199703000-00005
更新日期:1997-03-01 00:00:00
abstract::Although our current understanding is limited, epidemiologic investigation of Crohn's disease holds great promise. Certain aspects of the epidemiology are clear. The incidence of Crohn's disease, which has increased over the past few decades, may have reached a plateau. The disease has its peak onset in early life, wi...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198604000-00011
更新日期:1986-04-01 00:00:00
abstract::Helicobacter pylori antibody testing is accurate for diagnosing untreated patients. Rapid serum testing is as accurate as formal enzyme-linked immunosorbent assay (ELISA) testing. As whole blood fingerstick tests may become the diagnostic method of choice if they are of similar accuracy, 51 patients were studied who h...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199807000-00010
更新日期:1998-07-01 00:00:00
abstract:GOAL:To study the rate at which Helicobacter pylori infection is treated in an immigrant cohort after diagnosis by esophagogastroduodenoscopy (EGD). BACKGROUND:Gastric cancer is the second leading cause of cancer death worldwide, and is especially prevalent in East Asia; immigrants from this part of the world remain a...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,多中心研究
doi:10.1097/01.mcg.0000190755.33373.f9
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND AND AIM:Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal types of cancer; most patients die during the first 6 months after diagnosis. With a 5% 5-year survival rate, is the fourth leading cause of cancer death in developed countries. In this regard, several clinical, histopathologic and bio...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000793
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Guidelines for chronic hepatitis C virus (HCV) management have recommended that a liver biopsy be repeated at 3-year intervals for HIV/HCV-coinfected patients and 5-year intervals for those with HCV monoinfection to assess fibrosis progression. However, it is unclear if patients are willing to repeat this pr...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318266fe70
更新日期:2013-05-01 00:00:00
abstract::Several epidemiologic studies of Crohn's Disease (CD) from the northern hemisphere show high rates of the disease among Jews. Israel has absorbed many Jews from those countries and the rates of CD in Israel are lower than in their place of birth. Important, too, among immigrants from the middle east Mediterranean coun...
journal_title:Journal of clinical gastroenterology
pub_type: 社论
doi:
更新日期:1992-12-01 00:00:00
abstract:GOALS:To describe the association of untreated celiac disease with hyperhomocysteinemia and variants of the methylenetetrahydrofolicacid reductase (MTHFR) gene found in clinical practice. STUDY:Case studies with description of associated clinical, biochemical, and genetic findings and review of literature. RESULTS:Fi...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
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更新日期:2006-08-01 00:00:00
abstract::A detailed history and examination removes much of the vagueness from the symptoms of irritable bowel syndrome patients. The syndrome is much more homogeneous than suggested by the patient's complaints. Detailed questioning and examination contribute to further information in over two-thirds of patients. Examination r...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198312000-00005
更新日期:1983-12-01 00:00:00
abstract::Clinical reports suggest that nonsteroidal anti-inflammatory drugs (NSAIDs) use might induce esophageal symptoms and damage, including esophagitis, but experimental data are conflicting, and some indicate that NSAIDs improve mucosal damage. It is not known whether patients with endoscopically diagnosed esophagitis dur...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199812000-00007
更新日期:1998-12-01 00:00:00