Canadian Journal of Gastroenterology and Hepatology

https://www.hindawi.com/journals/cjgh/

List of Papers (Total 10,842)

Endoscopic Obturation of Esophageal and Gastric Varices with a Cyanoacrylic Tissue Adhesive

An original method of obturation of esophageal and gastric varices with a cyanoacrylic glue has been used for nine years. This method allows treatment of gastric and very large esophageal varices, which is difficult with common endoscopic sclerotherapy, and makes hemostasis in case of acute bleeding easier. There are few complications, none lethal.

Esophageal Variceal Ligation

Endoscopic sclerotherapy is an effective method for treating and eradicating acutely bleeding varices in repeated sessions; however, it is not ideal because of numerous serious complications. Endoscopic variceal ligation, developed to circumvent some of the side effects of sclerotherapy, controls actively bleeding varices in about 90% of cases. Of 146 patients treated with...

Endoscopic Obliteration of Fundal Varices

In cases of portal hypertension, the fundus of the stomach is second to the esophagus as the most likely area for varices, at a frequency of about 10%, in all patients having esophageal varices. It is relatively rare, probably due to the individual vascular anatomy rather than the level of portal pressure. The authors

Approach to Upper Gastrointestinal Bleeding - When to Treat?

Upper gastrointestinal bleeding from peptic ulcer is a life threatening emergency. Clinical risk factors for fatal outcome have been defined, and endoscopic predictors for rebleeding have been identified. Active ulcer bleeding at endoscopy carries an 80% chance of persistent or recurrent bleeding. A non bleeding visible vessel is associated with a 50% chance of rebleeding. These...

Review of Endoscopic Thermal Treatment of Peptic Ulcer Hemorrhage

Peptic ulcer hemorrhage is still an important cause of emergency surgery and death. The overall mortality is around 10% from gastrointestinal bleeding, and most of the preventable deaths occur in elderly patients with continued or recurrent bleeding from peptic ulcers. An effective nonsurgical method of hemostasis has long been recognized to be desirable. However it was only when...

Dermatomyositis with Kaposi’s Sarcoma in a Patient without Human Immunodeficiency Virus-1 Infection

The first case of dermatomyositis complicating cutaneous and visceral Kaposi’s sarcoma is presented in a 75-year-old man without human immunodeficiency virus infection. Dermatomyositis preceded a definitive diagnosis of Kaposi’s sarcoma by six months, although in retrospect unrecognized lesions may have presented simultaneously. He was treated with prednisone and azathioprine...

Decidualized Endometriosis Causing Inversion of the Appendix, Massive Hemorrhage and Fetal Death

An extraordinary case of inversion of the appendix due to decidualized endometriosis is reported. A 35-year-old woman presented at 3 7 weeks of pregnancy with acute massive rectal hemorrhage and fetal death. A limited right hemicolectomy was performed. The cecum contained an inverted appendix with an ulcerated tip. Histologically there was decidualized endometriosis in the ulcer...

Pharmacotherapy of Peptic Ulcer Disease

The etiology of peptic ulcer is multifactorial; except for omeprazole, all drugs used for the treatment of peptic ulcer result in healing with no statistical difference at four weeks. The healing rare increases with time for active medication and placebo, and is lower among smokers than nonsmokers for all drugs but misoprostol. Mucosal protectives (or ‘cytoprotectives’) as a...

Defence Mechanisms during Intestinal Infection

This review examines and compares host defence mechanisms during intestinal infection with three types of organisms: a virus, a bacterium and a nematode parasite (ie, transmissible gastroenteritis virus [TGEV], Helicobacter jejuni and Trichinella spiralis). Diarrhea is commonly associated with all of these infections. It appears that T spiralis initiates the most elaborate...

Esophageal Manometry with Provocative Testing in Patients with Noncardiac Angina-Like Chest Pain

In a five year period 238 of 594 esophageal manometric studies performed in the authors’ laboratory were done on patients whose major reason for referral was noncardiac angina-like chest pain. Standard eophageal manometry was performed followed by an acid-antacid perfusion period (Bernstein test) and then subcutaneous bethanechol (80 μg/kg to a maximum of 5 mg) was adminstered...

Mucinous Rectal Adenocarcinoma in Perianal Crohn’s Disease Fistulas

A 47-year-old male with longstanding Crohn’s disease complicated by perianal fistulous disease is described. In this patient, presentation with a large acute ischiorectal abscess resulted in diagnosis of a complicating mucinous adenocarcinoma. Despite the relatively high frequency of perianal complications in Crohn’s disease, diagnosis of carcinoma in this setting is difficult...

A Case of Yersinia Infection from the Middle East: Case Report and Literature Review

The authors report the first case of yersinia infection of the cecum, appendix and mesenteric lymph nodes from the Middle East, together with a literature review on yersiniosis. The case is unique in that the cecum was affected while the terminal ileum was free from disease.

Quantitative Liver Function Tests: A Realizable Goal?

A variety of tests has been used to assess liver function and predict hepatic functional reserve in patients with liver disease. These tests comprise clinical assessment, simple biochemical measurements and so-called ‘quantitative’ tests of liver function, ie, elimination rate measurements of exogenous markers such as drugs and other compounds. So far no single test or group of...

Enpostil Lowers Elevated Serum Gastrin Concentrations in Patients with Pernicious Anemia

A double-blind, randomized, crossover, placebo controlled study of Latin square design was conducted to determine the gastrin-lowering effects of a synthetic orally administered prostaglandin, enprostil, in fasted and fed patients with hypergastrinemia due to pernicious anemia. The study subjects were one male and six female patients between the ages of 39 and 76 years with known...

Sympathetic Nervous Regulation in Patients with Cirrhosis: Pathogenesis of Fluid Retention and Formation of Ascites

Increased circulating noradrenaline in patients with cirrhosis is due to enhanced sympathetic nervous activity and is not merely the result of decreased clearance of catecholamines. There is a direct relation between the level of arterial norndrenaline and severity of cirrhosis, increased portal pressure and fluid accumulation; patients with the hepatorenal syndrome exhibit the...

Subclinical Hepatic Encephalopathy in Cirrhotic Patients: Prevalence and Relationship to Liver Function

Neuropsychological tests were administered to 22 alcoholic cirrhotic patients, 20 nonalcoholic cirrhotic patients and 42 control subjects matched for age and educational background. Liver function estimated by Pugh score was identical in alcoholic and nonalcoholic cirrhotics. Thirty-two cirrhotic patients (76%) failed one or more psycho logical test. Performance was worse in...

Cerbral Venous Thrombosis in Ulcerative Colitis and Review of the Literature

A 30-year-old man with an eight year history of ulcerative colitis developed left occipital headache, mental confusion, dysphasia and right-sided weakness when his bowel disease was asymptomatic. Investigations revealed thrombosis of the cerebral sagittal sinus and left transverse sinus. The literature relating to cerebrovascular complications associated with ulcerative colitis...

Review of Laboraotory and Clinical Studies of Olestra, a Nonabsorbable Lipid

The classical understanding of fat digestion and absorption is provided as background for a review of research on olestra, a triglyceride-derived lipid that is not digested or absorbed from the intestinal lumen. Olestra (formerly ‘sucrose polyester’) is the generic name proposed for the mixture of the hexa, hepta and octa long chain fatty acid esters of sucrose. Olestra has the...

Small Bowel Transplantation: Current Clinical Status

With recent refinements in immunosuppression techniques, the first successful reports of small bowel transplantation in humans have now been made, increasing interest in bowel transplantation among clinicians and patients alike. This article reviews recent developments in understanding of the functional capabilities and requirements for effective immune suppression in bowel...

Sulphasalazine-Induced Pseudomembranous Colitis

An 18-year-old female with ankylosing spondylitis developed fever, abdominal pain and diarrhea on two occasions after starting sulphasalazine therapy. Flexible sigmoidoscopy revealed pseudomembranous colitis; fecal cultures were positive for Clostridium difficile; and C difficile toxin assay was positive. Despite the frequent use of sulphasalazine in the management of...

Spontaneous Rupture of a Nonparasitic Hepatic Cyst Associated with Peritonitis

The first report of a nonparnsitic cyst complicated by rupture and peritonitis is given. A 63-year-old female found to have a nonparasitic hepatic cyst was discharged from hospital when her symptoms of sharp intermittent pains in the right upper quadrant resolved spontaneously. Hours later, she was re-admitted with rupture and peritonitis. After hepatic cystojejunostomy (Roux-en...