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Gastroenterol. Insights, Volume 15, Issue 4 (December 2024) – 6 articles

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18 pages, 376 KiB

Open AccessReview

Non-Cirrhotic Ascites: Causes and Management

by Paul Carrier, Marilyne Debette-Gratien, Jérémie Jacques and Véronique Loustaud-Ratti

Gastroenterol. Insights 2024, 15(4), 926-943; https://doi.org/10.3390/gastroent15040065 - 17 Oct 2024

Viewed by 269

Abstract

Ascites is a common syndrome characterized by an excess of fluid in the peritoneum. While cirrhosis is the most common cause, a wide range of other conditions—such as cancer, right heart failure, and tuberculosis—can also lead to ascites, and multiple etiologies may be present simultaneously. Effective diagnosis and management are essential, primarily relying on clinical examination and paracentesis, guided by specific tests. Full article

(This article belongs to the Section Liver)

14 pages, 775 KiB

Open AccessArticle

Nutritional Status, Diet, and Intestinal Permeability of Mexican Children with Autism Spectrum Disorders

by Karina Alejandra Pedroza-García, Miriam Aracely Anaya-Loyola, Dolores Ronquillo, María del Carmen Caamaño, David Masuoka, Jorge Palacios-Delgado and Jorge L. Rosado

Gastroenterol. Insights 2024, 15(4), 912-925; https://doi.org/10.3390/gastroent15040064 - 16 Oct 2024

Viewed by 302

Abstract

Introduction: Autism spectrum disorder (ASD) comprises a group of developmental disorders characterized by deficits in social interaction and behavioral patterns. Children with ASD may face nutritional challenges, primarily due to their restrictive behaviors and frequent gastrointestinal issues. Objective: The objective of the present study was to assess nutritional status, dietary habits, and intestinal permeability in a sample of individuals with ASD. Methods: A cross-sectional study was conducted with 24 children and adolescents (both sexes), aged 4 to 18 years, living in two cities of Mexico (Aguascalientes and Querétaro). Weight and height were measured, and body mass index for age was calculated and compared using WHO Z-scores. Diet was assessed through three 24 h dietary recalls and a food frequency questionnaire. Intestinal permeability was evaluated using a lactulose/mannitol test by HPLC. Results: A high prevalence of malnutrition was observed; 12.5% of the participants were underweight, and 45.8% were overweight or obese. Children had a low intake of fiber, vitamin E, folate, potassium, zinc, and phosphorus and a high intake of sodium. On average, the intestinal permeability ratio was 0.09 ± 0.05, with 54.2% of the children exhibiting high intestinal permeability. Conclusions: It is advisable to develop food counseling strategies for children with ASD to prevent micronutrient deficiencies, promote healthy weight, and improve gastrointestinal integrity. Full article

(This article belongs to the Section Gastrointestinal Disease)

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8 pages, 5345 KiB

Open AccessCase Report

Laparoscopic Splenectomy for a Congenital Epidermoid Cyst in a 15-Year-Old Child—Case Report

by Denitza Kofinova, Yanko Pahnev, Edmond Rangelov, Ivan Vasilevski, Olga Bogdanova, Elena Ilieva and Hristo Shivachev

Gastroenterol. Insights 2024, 15(4), 904-911; https://doi.org/10.3390/gastroent15040063 - 13 Oct 2024

Viewed by 344

Abstract

Splenic epidermoid cysts are rare benign congenital tumors. However, if the cyst is not completely removed, it can reoccur. Laparoscopic splenectomy in children is being conducted more often, but it is a therapeutic challenge in cases of a giant cyst. We report a case of a 15-year-old girl who presented with nausea, anorexia and abdominal pain. The ultrasound showed a giant well-defined hypoechoic cyst with diffuse internal echoes. Computed tomography revealed a cystic mass (92/124/102 mm) without contrast enhancement. Anti-Echinococcus ELISA IgG was negative, and serum tumor markers CA 19-9 79.1 U/mL (N < 34) and CA-125 39.6 U/ML (N < 35) were elevated. Before the operation, the girl was vaccinated for Haemophilus influenzae, Pneumococci and Meningococci. Laparoscopic splenectomy was performed. The patient’s postoperative course was uneventful. Histopathology indicated a cyst walled by multilayered squamous epithelium positive for cytokeratin AE1/AE3. The diagnosis epidermoid cyst was confirmed. Full article

(This article belongs to the Section Gastrointestinal Disease)

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9 pages, 258 KiB

Open AccessArticle

The Effect of Body Composition on Osteoporosis Risk in Adults with Celiac Disease

by Kinga Skoracka, Michał Michalak, Alicja Ewa Ratajczak-Pawłowska, Anna Maria Rychter, Agnieszka Zawada, Agnieszka Dobrowolska and Iwona Krela-Kaźmierczak

Gastroenterol. Insights 2024, 15(4), 895-903; https://doi.org/10.3390/gastroent15040062 - 4 Oct 2024

Viewed by 417

Abstract

Background: Celiac disease (CD) has been linked with increased susceptibility to osteoporosis; therefore, we aimed to explore whether, in a group of patients with CD, body composition parameters impact bone parameters. Methods: This study covered 56 adults—47 women and 9 men—with CD, and 20 healthy controls—16 women and 4 men. Densitometry of the lumbar spine (L1–L4) and femoral neck (FN) was conducted using dual-energy X-ray absorptiometry (DXA). Body mass was measured by bioimpedance method. Furthermore, serum 25(OH)D and ionized calcium concentration were determined. Results: We found osteopenia in the FN in 19.65% of patients and in L1–L4 in 26.79% of the patients. One patient displayed evidence of osteoporosis in the L1–L4 region, while two patients (3.57%) exhibited similar findings in the FN. Significant positive correlations were observed between bone mineral density (BMD) and body mass, fat-free mass (FFM), muscle mass, and basal metabolic rate (BMR) for both L1–L4 and the FN, and body mass index (BMI) of L1–L4. Conclusions: In conclusion, people with CD are at an increased risk of decreased BMD. Patients with lower body mass, FFM, muscle mass, BMI, and BMR more often present with osteopenia and osteoporosis. Full article

(This article belongs to the Special Issue Feature Papers in Celiac Disease)

17 pages, 1053 KiB

Open AccessReview

Nutritional Consequences of Celiac Disease and Gluten-Free Diet

by Paola Ilaria Bianchi, Nicola Aronico, Giovanni Santacroce, Giacomo Broglio, Marco Vincenzo Lenti and Antonio Di Sabatino

Gastroenterol. Insights 2024, 15(4), 878-894; https://doi.org/10.3390/gastroent15040061 - 27 Sep 2024

Viewed by 1122

Abstract

Celiac disease is an immune-mediated condition triggered by gluten ingestion in genetically predisposed individuals. The global prevalence of celiac disease is significant, affecting approximately 1.4% of women and 0.7% of men, with incidence rates of 17.4 and 7.8 per 100,000 person-years, respectively. The clinical presentation of celiac disease may range from overt diarrhea and malabsorption to more subtle features such as nutritional deficiencies and extraintestinal manifestations. It is the most common cause of global malabsorption in Western countries. A life-long gluten-free diet is the only available treatment for celiac disease. Moreover, a gluten-free diet is often adopted by individuals without celiac disease, either to address non-celiac gluten sensitivity or for other reasons. This review aims to explore the current understandings of the nutritional consequences of untreated celiac disease and the impact of the gluten-free diet itself. Physicians and dietitians specializing in celiac disease should focus on providing a well-rounded nutritional scheme to address deficiencies caused by the disease and prevent the instauration of new nutritional imbalances. Full article

(This article belongs to the Special Issue Feature Papers in Celiac Disease)

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13 pages, 1100 KiB

Open AccessArticle

Resection of the Inferior Vena Cava Due to Tumor Involvement Allows Long-Term Survival in Different Neoplasms

by Isabel Jaén-Torrejimeno, Diego López-Guerra, Adela Rojas-Holguín, Antonio Enrique Gómez-Martin and Gerardo Blanco-Fernández

Gastroenterol. Insights 2024, 15(4), 865-877; https://doi.org/10.3390/gastroent15040060 - 26 Sep 2024

Viewed by 548

Abstract

Background: The involvement of the inferior vena cava in advanced abdominal tumors is a surgical challenge, given the high postoperative morbidity and poor long-term prognosis. Our goal was to analyze our experience, perioperative management, and results. Methods: We retrospectively evaluated short and long-term results of surgical resections of tumors with associated inferior vena cava resection performed in our facilities between 2012 and 2023. Results: A total of 25 patients were selected for our retrospective study: 3 with renal carcinoma, 5 with sarcoma, 12 with metastatic lesions, 2 with adrenal tumors, 1 pancreatic tumor, 1 extra-adrenal paraganglioma and 1 with hepatocellular carcinoma. Postoperative severe complications (Dindo-Clavien score ≥ IIIa) affected 36% of patients and the mortality rate was 8%. Partial resection with primary repair was performed in 13 patients (52%), with patch reconstruction in 6 (24%), and vascular reconstruction with prosthesis in 6 patients (24%). The mean disease-free survival was 7 months (IQR 2.5–11.5). Graft thrombosis occurred in 2 patients during follow-up. Conclusions: In selected patients, the resection of the inferior vena cava is a complex surgery with an assumable morbimortality and relative survival improvement. Full article

(This article belongs to the Collection Advances in Gastrointestinal Cancer)

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