BACKGROUND Traditional esophagogastroduodenoscopy(EGD),an invasive examination method,can cause discomfort and pain in patients.In contrast,magnetically controlled capsule endoscopy(MCE),a noninvasive method,is being ...BACKGROUND Traditional esophagogastroduodenoscopy(EGD),an invasive examination method,can cause discomfort and pain in patients.In contrast,magnetically controlled capsule endoscopy(MCE),a noninvasive method,is being applied for the detection of stomach and small intestinal diseases,but its application in treating esophageal diseases is not widespread.AIM To evaluate the safety and efficacy of detachable string MCE(ds-MCE)for the diagnosis of esophageal diseases.METHODS Fifty patients who had been diagnosed with esophageal diseases were pros-pectively recruited for this clinical study and underwent ds-MCE and conven-tional EGD.The primary endpoints included the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for patients with esophageal diseases.The secondary endpoints consisted of visualizing the esophageal and dentate lines,as well as the subjects'tolerance of the procedure.RESULTS Using EGD as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for esophageal disease detection were 85.71%,86.21%,81.82%,89.29%,and 86%,respectively.ds-MCE was more comfortable and convenient than EGD was,with 80%of patients feeling that ds-MCE examination was very comfortable or comfortable and 50%of patients believing that detachable string v examination was very convenient.CONCLUSION This study revealed that ds-MCE has the same diagnostic effects as traditional EGD for esophageal diseases and is more comfortable and convenient than EGD,providing a novel noninvasive method for treating esophageal diseases.展开更多
Focal dermal hypoplasia(FDH) is a rare disorder of the mesodermal and ectodermal tissues. Here we present an eight-year-old female known to have FDH who presents with poor weight gain and dysphagia. She was diagnosed ...Focal dermal hypoplasia(FDH) is a rare disorder of the mesodermal and ectodermal tissues. Here we present an eight-year-old female known to have FDH who presents with poor weight gain and dysphagia. She was diagnosed with multiple esophageal papillomas and eosinophilic esophagitis. She was successfully treated with argon plasma coagulation and ingested fluticasone propionate, which has not been described previously in a child.展开更多
<b><span style="font-family:Verdana;">Background:</span></b></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span...<b><span style="font-family:Verdana;">Background:</span></b></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Esophageal strictures are considered to be </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">one </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">of the most </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">challenging matters for gastroenterologist, general and thoracic surgeons in diagnosis and management. They can be grouped into three general categories: intrinsic diseases, extrinsic diseases, and diseases that disrupt esophageal peristalsis and/or lower esophageal sphincter (LES) function. Crohn’s disease (CD) is a very rare cause of esophageal stricture. The prevalence of esophageal CD ranges from 1% to 2% in adults with CD. It is almost diagnosed lately when complications have occurred as Strictures, fissures, esophagobronchial fistulas, and mediastinal abscesses. </span><b><span style="font-family:Verdana;">Case Report: </span></b><span style="font-family:Verdana;">Thirty-nine years old Kurdish patient, referred to our department for evaluation. Although many con</span><span style="font-family:Verdana;">sultations during the last two years, the Pt was still undiagnosed. She had</span><span style="font-family:Verdana;"> progressive dysphagia, and weight loss of about 25 kg. She had no other digestive or extra digestive complaint, nor caustic ingestion history and nor drug his</span><span style="font-family:Verdana;">tory.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Chest CT scan and UGI Contrast study revealed diffuse smooth an</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">d </span><span style="font-family:Verdana;">regular esophageal stenosis.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Attempts to do upper endoscopy and biops</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">y failed due to severe stenosis. Prolonged medical history and radiologic signs exclude malignancy, so esophagectomy with stomach pull-through was done by the aid of VATS and laparoscopy with excellent results. Pathological finding of the resected esophagus suggested the diagnosis of Crohn’s disease CD.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusions: </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">CD is a rare cause of esophageal stricture and still to be a challenging early diagnosis due to the low specificity of clinical manifestations (aphthous ulcers), histologic findings (absence of granulomas), and endoscopic findings. So many patients have been diagnosed with complications (esophageal strictures, fistulas) which needed surgical treatment, adding greater morbidity and mortality. MIS (thoracoscopy-laparoscopy) is valuable in decreasing the morbidity and mortality and improving the quality of life for those patients.展开更多
Traditional medical imaging,including ultrasound,computed tomography,magnetic resonance imaging,or positron emission tomography,remains widely used diagnostic modalities for gastrointestinal diseases at present.These ...Traditional medical imaging,including ultrasound,computed tomography,magnetic resonance imaging,or positron emission tomography,remains widely used diagnostic modalities for gastrointestinal diseases at present.These modalities are used to assess changes in morphology,attenuation,signal intensity,and enhancement characteristics.Gastrointestinal tumors,especially malignant tumors,are commonly seen in clinical practice with an increasing number of deaths each year.Because the imaging manifestations of different diseases usually overlap,accurate early diagnosis of tumor lesions,noninvasive and effective evaluation of tumor staging,and prediction of prognosis remain challenging.Fortunately,traditional medical images contain a great deal of important information that cannot be recognized by human eyes but can be extracted by artificial intelligence(AI)technology,which can quantitatively assess the heterogeneity of lesions and provide valuable information,including therapeutic effects and patient prognosis.With the development of computer technology,the combination of medical imaging and AI technology is considered to represent a promising field in medical image analysis.This new emerging field is called“radiomics”,which makes big data mining and extraction from medical imagery possible and can help clinicians make effective decisions and develop personalized treatment plans.Recently,AI and radiomics have been gradually applied to lesion detection,qualitative and quantitative diagnosis,histopathological grading and staging of tumors,therapeutic efficacy assessment,and prognosis evaluation.In this minireview,we briefly introduce the basic principles and technology of radiomics.Then,we review the research and application of AI and radiomics in gastrointestinal diseases,especially diagnostic advancements of radiomics in the differential diagnosis,treatment option,assessment of therapeutic efficacy,and prognosis evaluation of esophageal,gastric,hepatic,pancreatic,and colorectal diseases.展开更多
基金the Science and Technology Commission of Shanghai,No.18DZ1930309.
文摘BACKGROUND Traditional esophagogastroduodenoscopy(EGD),an invasive examination method,can cause discomfort and pain in patients.In contrast,magnetically controlled capsule endoscopy(MCE),a noninvasive method,is being applied for the detection of stomach and small intestinal diseases,but its application in treating esophageal diseases is not widespread.AIM To evaluate the safety and efficacy of detachable string MCE(ds-MCE)for the diagnosis of esophageal diseases.METHODS Fifty patients who had been diagnosed with esophageal diseases were pros-pectively recruited for this clinical study and underwent ds-MCE and conven-tional EGD.The primary endpoints included the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for patients with esophageal diseases.The secondary endpoints consisted of visualizing the esophageal and dentate lines,as well as the subjects'tolerance of the procedure.RESULTS Using EGD as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for esophageal disease detection were 85.71%,86.21%,81.82%,89.29%,and 86%,respectively.ds-MCE was more comfortable and convenient than EGD was,with 80%of patients feeling that ds-MCE examination was very comfortable or comfortable and 50%of patients believing that detachable string v examination was very convenient.CONCLUSION This study revealed that ds-MCE has the same diagnostic effects as traditional EGD for esophageal diseases and is more comfortable and convenient than EGD,providing a novel noninvasive method for treating esophageal diseases.
文摘Focal dermal hypoplasia(FDH) is a rare disorder of the mesodermal and ectodermal tissues. Here we present an eight-year-old female known to have FDH who presents with poor weight gain and dysphagia. She was diagnosed with multiple esophageal papillomas and eosinophilic esophagitis. She was successfully treated with argon plasma coagulation and ingested fluticasone propionate, which has not been described previously in a child.
文摘<b><span style="font-family:Verdana;">Background:</span></b></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Esophageal strictures are considered to be </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">one </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">of the most </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">challenging matters for gastroenterologist, general and thoracic surgeons in diagnosis and management. They can be grouped into three general categories: intrinsic diseases, extrinsic diseases, and diseases that disrupt esophageal peristalsis and/or lower esophageal sphincter (LES) function. Crohn’s disease (CD) is a very rare cause of esophageal stricture. The prevalence of esophageal CD ranges from 1% to 2% in adults with CD. It is almost diagnosed lately when complications have occurred as Strictures, fissures, esophagobronchial fistulas, and mediastinal abscesses. </span><b><span style="font-family:Verdana;">Case Report: </span></b><span style="font-family:Verdana;">Thirty-nine years old Kurdish patient, referred to our department for evaluation. Although many con</span><span style="font-family:Verdana;">sultations during the last two years, the Pt was still undiagnosed. She had</span><span style="font-family:Verdana;"> progressive dysphagia, and weight loss of about 25 kg. She had no other digestive or extra digestive complaint, nor caustic ingestion history and nor drug his</span><span style="font-family:Verdana;">tory.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Chest CT scan and UGI Contrast study revealed diffuse smooth an</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">d </span><span style="font-family:Verdana;">regular esophageal stenosis.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Attempts to do upper endoscopy and biops</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">y failed due to severe stenosis. Prolonged medical history and radiologic signs exclude malignancy, so esophagectomy with stomach pull-through was done by the aid of VATS and laparoscopy with excellent results. Pathological finding of the resected esophagus suggested the diagnosis of Crohn’s disease CD.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusions: </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">CD is a rare cause of esophageal stricture and still to be a challenging early diagnosis due to the low specificity of clinical manifestations (aphthous ulcers), histologic findings (absence of granulomas), and endoscopic findings. So many patients have been diagnosed with complications (esophageal strictures, fistulas) which needed surgical treatment, adding greater morbidity and mortality. MIS (thoracoscopy-laparoscopy) is valuable in decreasing the morbidity and mortality and improving the quality of life for those patients.
文摘Traditional medical imaging,including ultrasound,computed tomography,magnetic resonance imaging,or positron emission tomography,remains widely used diagnostic modalities for gastrointestinal diseases at present.These modalities are used to assess changes in morphology,attenuation,signal intensity,and enhancement characteristics.Gastrointestinal tumors,especially malignant tumors,are commonly seen in clinical practice with an increasing number of deaths each year.Because the imaging manifestations of different diseases usually overlap,accurate early diagnosis of tumor lesions,noninvasive and effective evaluation of tumor staging,and prediction of prognosis remain challenging.Fortunately,traditional medical images contain a great deal of important information that cannot be recognized by human eyes but can be extracted by artificial intelligence(AI)technology,which can quantitatively assess the heterogeneity of lesions and provide valuable information,including therapeutic effects and patient prognosis.With the development of computer technology,the combination of medical imaging and AI technology is considered to represent a promising field in medical image analysis.This new emerging field is called“radiomics”,which makes big data mining and extraction from medical imagery possible and can help clinicians make effective decisions and develop personalized treatment plans.Recently,AI and radiomics have been gradually applied to lesion detection,qualitative and quantitative diagnosis,histopathological grading and staging of tumors,therapeutic efficacy assessment,and prognosis evaluation.In this minireview,we briefly introduce the basic principles and technology of radiomics.Then,we review the research and application of AI and radiomics in gastrointestinal diseases,especially diagnostic advancements of radiomics in the differential diagnosis,treatment option,assessment of therapeutic efficacy,and prognosis evaluation of esophageal,gastric,hepatic,pancreatic,and colorectal diseases.