Gastroenterology Insights

13 pages, 1365 KiB

Open AccessFeature PaperArticle

Relationship Between Hepatitis B Viral Load and Laboratory Parameters in HBsAg-Positive Patients: Insights from the Sub-Himalayan Region

by Ashish Negi, Priyal Anand, Diksha Diksha, Shailender Negi, Shailesh Kumar Gupta, Deepjyoti Kalita and Yogendra Pratap Mathuria

Gastroenterol. Insights 2025, 16(3), 29; https://doi.org/10.3390/gastroent16030029 - 16 Aug 2025

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Abstract

Introduction: Hepatitis B is the most prevalent virus that causes severe liver infection worldwide. According to the current guidelines, the HBV viral load and other factors can help in treatment decisions. Therefore, the present study explores the relationship between the HBV viral load [...] Read more.

Introduction: Hepatitis B is the most prevalent virus that causes severe liver infection worldwide. According to the current guidelines, the HBV viral load and other factors can help in treatment decisions. Therefore, the present study explores the relationship between the HBV viral load and blood-based laboratory parameters. Methods: The HBV viral load was evaluated in blood samples from 159 HBsAg-positive patients (ICT-positive). The viral load was categorized as high (above 200,000 IU/mL), moderate (between 2000 and 200,000 IU/mL), or low (below 2000 IU/mL). The viral load was then compared with laboratory parameters. Results: A significant association was observed between the Hepatitis B viral load and the patient’s age (p < 0.01). The males showed a substantially higher viral load, with 29.2% of the male patients exhibiting elevated levels, compared to 11% of the females. A statistically significant correlation was found between the viral load and liver enzymes, specifically AST (p < 0.005) and ALT (p < 0.04), as well as calcium (p < 0.01). Notably, the elevated ALT and AST levels were more pronounced in the patients with moderate and high viral loads, suggesting a potential link to liver dysfunction. A remarkable insight uncovered in our study revolves around the notable increase in the serum calcium levels (p < 0.01). Conclusions: The AST, ALT, and serum calcium levels were the most altered parameters with high HBV viral load. Though limited reports are available on altered serum calcium levels, they could serve as potential laboratory markers for assessing disease progression in HBV infection. Moreover, focusing on potential therapies to normalize the AST, ALT, and serum calcium levels could offer promising avenues for combating HBV infection. Full article

(This article belongs to the Section Liver)

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13 pages, 873 KiB

Open AccessArticle

Impact of Endoscopic Band Ligation on Gastric Complications Associated with Portal Hypertension

by Maria Luisa Gambardella, Giulia Fabiano, Rocco Spagnuolo, Rosanna De Marco, Ileana Luppino, Giusi Franco, Francesco Rettura, Mario Verta, Francesco Luzza and Ludovico Abenavoli

Gastroenterol. Insights 2025, 16(3), 28; https://doi.org/10.3390/gastroent16030028 - 6 Aug 2025

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Abstract

Background/Objectives: Clinically significant portal hypertension (CSPH) in cirrhotic patients impacts mortality rates and quality of life. CSPH increases the risk of systemic decompensation and could predispose to the deterioration of portal hypertension (PH)–gastric complications, such as portal hypertensive gastropathy (PHG) and portal hypertensive [...] Read more.

Background/Objectives: Clinically significant portal hypertension (CSPH) in cirrhotic patients impacts mortality rates and quality of life. CSPH increases the risk of systemic decompensation and could predispose to the deterioration of portal hypertension (PH)–gastric complications, such as portal hypertensive gastropathy (PHG) and portal hypertensive polyps (PHPs). In the management of CSPH with high-risk varices, endoscopic band ligation (EBL) is effective in preventing variceal bleeding. However, this procedure has several drawbacks, ranging from its inability to treat PH to the potential development of significant PH–gastric complications. The aim of our study is to evaluate endoscopic changes in PHG, PHPs, and gastric varices before and after the obliteration of esophageal varices, highlighting the potential risks of EBL. Methods: We retrospectively evaluated forty-four patients who underwent EBL for esophageal varices in emergency and elective settings, according to Baveno VII guidelines. We assessed the presence and severity of PHG, the status of gastric varices, and the number of PHPs before and after the eradication of esophageal varices. We used Fisher’s exact test and t-tests to compare the endoscopic and clinical-laboratory data statistically. A p-value < 0.05 was considered statistically significant. Results: This study found that after the eradication of varices, there was a significant worsening of PHG in 28 patients (63%) compared to before the procedure (p < 0.05). The condition remained stable in 14 patients (31%). However, it is worth noting that 90% of the patients exhibited severe PHG at baseline. Additionally, the absence of ascites and the non-administration of beta blockers at baseline were independent risk factors for worsening PHG (p < 0.05). Along with the deterioration of PHG, three patients (7%) developed gastric varices, all classified as type 1 gastroesophageal varices, and in two patients (4.5%), PHPs were formed. In particular, out of these two cases, the number of PHPs increased from one to two compared to the baseline. Conclusions: Our study underscores the association of EBL with a general worsening of PH–gastric complications and the protective effect of beta blockers in this context. Despite these promising results, future studies are needed to assess whether the worsening of PH–gastric complications is sustained over time and whether it is associated with a deterioration in clinical outcomes in patients with cirrhosis. Such evidence could help guide a more informed therapeutic decision between EBL and beta blockers. Full article

(This article belongs to the Special Issue Advances in the Management of Gastrointestinal and Liver Diseases)

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11 pages, 936 KiB

Open AccessArticle

Endoscopic Ultrasound-Guided Drainage for Post-Pancreatitis and Post-Surgical Peripancreatic Collections: A Retrospective Evaluation of Outcomes and Predictors of Success

by Nadica Shumka and Petko Ivanov Karagyozov

Gastroenterol. Insights 2025, 16(3), 27; https://doi.org/10.3390/gastroent16030027 - 1 Aug 2025

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Abstract

Background: Peripancreatic collections (PPCs) are a frequent and severe complication of acute and chronic pancreatitis, as well as pancreatic surgery, often requiring interventions to treat and prevent infection, gastric obstruction, and other complications. Endoscopic ultrasound (EUS)-guided drainage has emerged as a minimally invasive [...] Read more.

Background: Peripancreatic collections (PPCs) are a frequent and severe complication of acute and chronic pancreatitis, as well as pancreatic surgery, often requiring interventions to treat and prevent infection, gastric obstruction, and other complications. Endoscopic ultrasound (EUS)-guided drainage has emerged as a minimally invasive alternative to surgical and percutaneous approaches, offering reduced morbidity and shorter recovery times. However, the effectiveness of EUS-guided drainage in post-surgical PPCs remains underexplored. Methods: This retrospective, single-center study evaluated the technical and clinical outcomes of EUS-guided drainage in patients with PPCs between October 2021 and December 2024. Patients were categorized as having post-pancreatitis or post-surgical PPCs. Technical success, clinical success, complications, recurrence rates, and the need for reintervention were assessed. Results: A total of 50 patients underwent EUS-guided drainage, including 42 (84%) with post-pancreatitis PPCs and 8 (16%) with post-surgical PPCs. The overall technical success rate was 100%, with clinical success achieved in 96% of cases. Lumen-apposing metal stents (LAMSs) were used in 84% of patients, including 7.1% as a dual-gate salvage strategy after the failure of double-pigtail drainage. The complication rate was 24%, with infection being the most common (16%). The recurrence rate was 25%, with no significant difference between post-pancreatitis and post-surgical cases. Patients with walled-off necrosis had a significantly higher reintervention rate (35%) than those with pseudocysts (18%; p = 0.042). Conclusions: EUS-guided drainage is a highly effective and safe intervention for PPCs, including complex post-surgical cases. The 100% technical success rate reinforces its reliability, even in anatomically altered post-surgical collections. While recurrence rates remain a consideration, EUS-guided drainage offers a minimally invasive alternative to surgery, with comparable outcomes in both post-pancreatitis and post-surgical patients. Future multi-center studies should focus on optimizing treatment strategies and reducing recurrence in high-risk populations. Full article

(This article belongs to the Section Pancreas)

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12 pages, 294 KiB

Open AccessReview

Targeting Advanced Pancreatic Ductal Adenocarcinoma: A Practical Overview

by Chiara Citterio, Stefano Vecchia, Patrizia Mordenti, Elisa Anselmi, Margherita Ratti, Massimo Guasconi and Elena Orlandi

Gastroenterol. Insights 2025, 16(3), 26; https://doi.org/10.3390/gastroent16030026 - 30 Jul 2025

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Abstract

Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest solid tumors, with a five-year overall survival rate below 10%. While the introduction of multi-agent chemotherapy regimens has improved outcomes marginally, most patients with advanced disease continue to have limited therapeutic options. Molecular [...] Read more.

Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest solid tumors, with a five-year overall survival rate below 10%. While the introduction of multi-agent chemotherapy regimens has improved outcomes marginally, most patients with advanced disease continue to have limited therapeutic options. Molecular profiling has uncovered actionable genomic alterations in select subgroups of PDAC, yet the clinical impact of targeted therapies remains modest. This review aims to provide a clinically oriented synthesis of emerging molecular targets in PDAC, their therapeutic relevance, and practical considerations for biomarker testing, including current FDA and EMA indications. Methods: A narrative review was conducted using data from PubMed, Embase, Scopus, and international guidelines (NCCN, ESMO, ASCO). The selection focused on evidence published between 2020 and 2025, highlighting molecularly defined PDAC subsets and the current status of targeted therapies. Results: Actionable genomic alterations in PDAC include KRAS G12C mutations, BRCA1/2 and PALB2-associated homologous recombination deficiency, MSI-H/dMMR status, and rare gene fusions involving NTRK, RET, and NRG1. While only a minority of patients are eligible for targeted treatments, early-phase trials and real-world data have shown promising results in these subgroups. Testing molecular profiling is increasingly standard in advanced PDAC. Conclusions: Despite the rarity of targetable mutations, systematic molecular profiling is critical in advanced PDAC to guide off-label therapy or clinical trial enrollment. A practical framework for identifying and acting on molecular targets is essential to bridge the gap between precision oncology and clinical management. Full article

(This article belongs to the Special Issue Advances in the Management of Gastrointestinal and Liver Diseases)

18 pages, 529 KiB

Open AccessArticle

Perspectives on Mail-Based Fecal Testing for Colorectal Cancer Screening in Bulgaria: A Survey of Gastroenterologists

by Kostadin Yordanov Dimitrov, Vladislav Velchev, Nely Danailova, Elena Staneva, Teodor Koparanov, Trifon Diankov, Teodora Gencheva, Bozhidar Valkov, Eleonora Hristova-Atanasova, Georgi Iskrov and Rumen Stefanov

Gastroenterol. Insights 2025, 16(3), 25; https://doi.org/10.3390/gastroent16030025 - 26 Jul 2025

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Abstract

Background: Bulgaria carries a high burden of colorectal cancer (CRC) but, at the start of this study, lacked a nationwide organized screening program. Understanding specialist views (particularly on mail-based fecal testing) is essential for effective policy development. Objective: The objective is to assess [...] Read more.

Background: Bulgaria carries a high burden of colorectal cancer (CRC) but, at the start of this study, lacked a nationwide organized screening program. Understanding specialist views (particularly on mail-based fecal testing) is essential for effective policy development. Objective: The objective is to assess the attitudes towards, practices of, and perceived barriers to CRC screening among Bulgarian gastroenterologists, with a focus on the feasibility of mail-based fecal occult blood testing (FOBT). Methods: A cross-sectional survey of 38 gastroenterologists examined clinical use of FOBT, screening method preferences, and perceived systemic and patient-level barriers to CRC screening. Results: Among respondents, 57.89% reported using FOBT in clinical practice, and 71.05% indicated they would undergo the test themselves and recommend it to relatives. Colonoscopy was the preferred diagnostic tool for 84.21% of participants; however, the existing literature raises concerns about its feasibility for large-scale population screening. Key systemic barriers, rated on a 5-point Likert scale, included financial constraints (mean = 3.08), inadequate infrastructure (2.89), and healthcare workforce shortages (2.71). Patient-level barriers were led by low health literacy (4.13), lack of motivation (3.95), and procedural fears (3.26). A majority (84.38%) believed that mail-based FOBT would increase screening uptake, and 57.89% supported annual distribution of test kits. Nearly all respondents (97.37%) favored initiating screening at age 50. Conclusions: This study highlights strong support among Bulgarian gastroenterologists for a national CRC screening program, with particular endorsement of mail-based FOBT. Despite acknowledged systemic and population-level barriers, the findings suggest that such an approach could increase screening coverage, promote early detection, and support the strategic rollout of Bulgaria’s emerging cancer control initiatives. Full article

(This article belongs to the Section Gastrointestinal Disease)

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16 pages, 266 KiB

Open AccessReview

Risk Scores in Acute Lower Gastrointestinal Bleeding: Current Evidence and Clinical Applications

by Truong Thi Do, Dung Thi My Vo and Thong Duy Vo

Gastroenterol. Insights 2025, 16(3), 24; https://doi.org/10.3390/gastroent16030024 - 8 Jul 2025

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Abstract

Lower gastrointestinal bleeding (LGIB) is a frequent and potentially life-threatening clinical condition. Over the past two decades, several prognostic scoring systems have been developed to stratify risk and guide the management of patients with LGIB. This comprehensive review aims to summarize and compare [...] Read more.

Lower gastrointestinal bleeding (LGIB) is a frequent and potentially life-threatening clinical condition. Over the past two decades, several prognostic scoring systems have been developed to stratify risk and guide the management of patients with LGIB. This comprehensive review aims to summarize and compare the current evidence on the utility, accuracy, and limitations of key LGIB scoring systems, including the Glasgow-Blatchford Score (GBS), AIMS65, ABC score, Oakland score, SALGIB, CHAMPS, and Rockall score. We conducted a structured literature review of studies evaluating these scores in adult patients with LGIB. For each scoring system, we analyzed its origin, components, intended use, and predictive performance regarding clinical outcomes such as severe bleeding, transfusion requirement, in-hospital mortality, rebleeding, and safe discharge. Comparative analyses of diagnostic accuracy were extracted where available. Our findings indicate that while no single score offers comprehensive predictive accuracy across all outcomes, certain tools are particularly effective for specific endpoints. The Oakland and GBS scores are useful for identifying patients at low risk who may be managed safely as outpatients. The ABC and CHAMPS scores demonstrate superior performance in predicting mortality, especially in elderly or comorbid populations. SALGIB, a newer score developed in Vietnam, shows promising performance for early triage but requires further validation. The Rockall score, although historically valuable in upper GI bleeding, offers limited applicability in LGIB due to its reliance on post-endoscopic findings. In conclusion, multiple prognostic tools are now available to support early decision-making in LGIB. Their optimal use requires understanding their strengths, limitations, and appropriate clinical contexts. Integrating these scores into routine practice, along with clinical judgment, can enhance patient outcomes and resource allocation. Full article

(This article belongs to the Section Gastrointestinal Disease)

17 pages, 2953 KiB

Open AccessArticle

Effects of Aronia melanocarpa-Based Fruit Juices on Metabolic Dysfunction-Associated Fatty Liver Disease in Rats

by Antoaneta Georgieva, Miroslav Eftimov, Nadezhda Stefanova, Maria Tzaneva, Petko Denev and Stefka Valcheva-Kuzmanova

Gastroenterol. Insights 2025, 16(3), 23; https://doi.org/10.3390/gastroent16030023 - 8 Jul 2025

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Abstract

Background/Objective: Metabolic dysfunction-associated fatty liver disease (MAFLD) is defined by the presence of hepatic steatosis, and is associated with obesity, diabetes, and other metabolic alterations. Feeding rats with a high-fat high-fructose (HFHF) diet is a reproducible experimental model of obesity/metabolic syndrome and [...] Read more.

Background/Objective: Metabolic dysfunction-associated fatty liver disease (MAFLD) is defined by the presence of hepatic steatosis, and is associated with obesity, diabetes, and other metabolic alterations. Feeding rats with a high-fat high-fructose (HFHF) diet is a reproducible experimental model of obesity/metabolic syndrome and the related MAFLD. Aronia melanocarpa, Rosa canina, and Alchemilla vulgaris are polyphenol-rich plants with proven health benefits. The aim of this study was to reveal the effects of four Aronia melanocarpa-based fruit juices (AMBFJs) in HFHF-fed rats. Methods: The AMBFJs were AM20 and AM60 (produced from aronia berries at 20 °C and 60 °C, respectively), AMRC (aronia juice with Rosa canina), and AMAV (aronia juice with Alchemilla vulgaris). Male Wistar rats were allocated to 6 groups. Except for the Control, the rest of the groups were fed an HFHF diet for 60 days. Throughout the experiment, each of the AMBFJs was administered to one HFHF-fed group. Results: HFHF-fed rats had an increased calorie intake on the background of increased liquid and decreased food consumption. At the end of the experiment, they had similar body weights, slightly increased fat indices, increased levels of blood lipids and liver enzymes, as well as typical histopathological changes in liver and adipose tissue. AMBFJs-treated animals showed improvement in most of these parameters, especially in triglyceride levels, liver enzymes, and the histopathological changes in the liver and fat. AMAV, the juice with the highest polyphenolic content, had the highest effect on adiposity. Conclusion: In HFHF-fed rats, AMBFJs exerted beneficial effects on MAFLD probably due to their polyphenolic ingredients. Full article

(This article belongs to the Section Gastrointestinal Disease)

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Graphical abstract

15 pages, 499 KiB

Open AccessSystematic Review

From in Utero to Gut: The Unseen Impact of Early-Life Vitamin D Deficiency on the Gastrointestinal System—A Systematic Review

by Artemisia Kokkinari, Evangelia Antoniou, Kleanthi Gourounti, Eirini Orovou, Maria Dagla, Antigoni Sarantaki and Georgios Iatrakis

Gastroenterol. Insights 2025, 16(3), 22; https://doi.org/10.3390/gastroent16030022 - 4 Jul 2025

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Abstract

Background: Vitamin D is increasingly recognized not only for its role in skeletal development but also for its immunomodulatory and gastrointestinal effects. Maternal and neonatal vitamin D deficiency (VDD) has been associated with alterations in gut microbiota, impaired intestinal barrier integrity, and increased [...] Read more.

Background: Vitamin D is increasingly recognized not only for its role in skeletal development but also for its immunomodulatory and gastrointestinal effects. Maternal and neonatal vitamin D deficiency (VDD) has been associated with alterations in gut microbiota, impaired intestinal barrier integrity, and increased susceptibility to inflammatory conditions in neonates. However, the exact mechanisms linking perinatal vitamin D status to neonatal gastrointestinal morbidity remain incompletely understood. Methods: This review synthesizes current evidence (2015–2024) from clinical studies, animal models, and mechanistic research on the impact of VDD during pregnancy and the neonatal period on gastrointestinal health. Databases such as PubMed, Scopus, and Web of Science were systematically searched using keywords, including “vitamin D”, “neonate”, “gut microbiome”, “intestinal barrier”, and “necrotizing enterocolitis”. Results: Emerging data suggest that VDD in utero and postnatally correlates with dysbiosis, increased intestinal permeability, and elevated inflammatory responses in neonates. Notably, low 25(OH)D levels in mothers and newborns have been linked with a higher incidence of necrotizing enterocolitis (NEC), delayed gut maturation, and altered mucosal immunity. Vitamin D appears to modulate the expression of tight junction proteins, regulate antimicrobial peptides, and maintain microbial diversity through the vitamin D receptor (VDR). Conclusions: Understanding the gastrointestinal implications of early-life VDD opens a potential window for preventive strategies in neonatal care. Timely maternal supplementation and targeted neonatal interventions may mitigate gut-related morbidities and improve early-life health outcomes. Further longitudinal and interventional studies are warranted to clarify causality and optimal intervention timing. Full article

(This article belongs to the Section Gastrointestinal Disease)

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10 pages, 2812 KiB

Open AccessCase Report

Hiccups as the First Symptom of a Complication of Total Gastrectomy for Gastric Cancer with a Negative Objective Abdominal Examination: A Case Report and Review of the Literature

by Francesco Lamacchia, Genny Mattara, Francesca Tolin, Beatrice Maddalon and Pierluigi Pilati

Gastroenterol. Insights 2025, 16(3), 21; https://doi.org/10.3390/gastroent16030021 - 3 Jul 2025

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Abstract

Total gastrectomy with D2 lymphadenectomy for gastric cancer is a complex surgical procedure with a moderate complication rate. Sometimes, some complications may have a misleading onset without a clear clinical presentation and blood test changes. In this case report, hiccups were the main [...] Read more.

Total gastrectomy with D2 lymphadenectomy for gastric cancer is a complex surgical procedure with a moderate complication rate. Sometimes, some complications may have a misleading onset without a clear clinical presentation and blood test changes. In this case report, hiccups were the main symptom of subdiaphragmatic fluid collection after total gastrectomy. Full article

(This article belongs to the Section Gastrointestinal Disease)

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17 pages, 2241 KiB

Open AccessSystematic Review

Increased Overall Mortality in Patients Admitted for Gastrointestinal Bleeding and COVID-19 Infection Compared to No COVID-19 Infection: A Systematic Review and Meta-Analysis

by Sergiu Marian Cazacu, Adina Turcu-Stiolica, Cristina Maria Marginean and Ion Rogoveanu

Gastroenterol. Insights 2025, 16(3), 20; https://doi.org/10.3390/gastroent16030020 - 30 Jun 2025

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Abstract

(1) Background: Patients admitted for gastrointestinal bleeding (GIB) who are diagnosed with COVID-19 at presentation may face significant therapeutic challenges. The delicate balance between the use of anticoagulant and anti-inflammatory therapy to address COVID-19 and hemostasis targets can, in turn, lead to delays [...] Read more.

(1) Background: Patients admitted for gastrointestinal bleeding (GIB) who are diagnosed with COVID-19 at presentation may face significant therapeutic challenges. The delicate balance between the use of anticoagulant and anti-inflammatory therapy to address COVID-19 and hemostasis targets can, in turn, lead to delays in COVID-19 treatment until bleeding is controlled. The published systematic reviews and meta-analyses that were reviewed included patients with both GIB and COVID-19 regardless of GIB presence at admission, and a separate analysis of patients admitted for GIB and tested for COVID-19 infection during hospitalization was not performed. (2) Methods: PubMed, Web of Science, and Scopus databases were used to access articles published from 1 December 2019 to 20 December 2024. Retrospective studies involving human subjects with GIB and COVID-19 were included in the final analysis. The exclusion criteria were as follows: pediatric population studies; the absence of a GIB control group; reviews, conference abstracts, expert opinions, and letters. The risk of bias in the included studies was assessed using the rank correlation test and Begg’s and Egger’s regression tests. We estimated the outcomes using the pooled odds ratio (OR) and the 95% confidence interval (95% CI). (3) Results: Seven studies, which included 3291 patients admitted for GIB who tested positive for COVID-19 infection, were included in our systematic review; four studies with a control group of patients with GIB but without COVID-19 infection were included in our meta-analysis. The odds of mortality among COVID-19-infected patients admitted for GIB were 3.80. There was heterogeneity regarding the site of GIB (some studies included all forms of GIB, others included only UGIB) and the study period (most studies included only patients from the first pandemic wave, and only one study reported cases from the first 2 years of the pandemic, including the delta pandemic wave). (4) Conclusions: COVID-19 infection in patients admitted for GIB was associated with a higher overall mortality rate. Full article

(This article belongs to the Section Gastrointestinal Disease)

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13 pages, 499 KiB

Open AccessArticle

Point-of-Care Ultrasound for the Early Detection of Intrahepatic Biliary Tract Dilatation: A Local Study in a Basic Emergency Service

by Sergio Miravent, Bruna Vaz, Manuel Duarte Lobo, Cármen Jimenez, Pedro Pablo, Teresa Figueiredo, Narciso Barbancho, Miguel Ventura and Rui Pedro de Almeida

Gastroenterol. Insights 2025, 16(3), 19; https://doi.org/10.3390/gastroent16030019 - 29 Jun 2025

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Abstract

Background/Objectives: Ultrasonography is a diagnostic modality characterized by high sensitivity in detecting hepato-biliary pathology, particularly intrahepatic biliary duct dilation. This study compares the sonographic findings obtained by a radiographer/sonographer in a Basic Emergency Service (BES) using Point-of-Care Ultrasonography (POCUS) in Portugal with the [...] Read more.

Background/Objectives: Ultrasonography is a diagnostic modality characterized by high sensitivity in detecting hepato-biliary pathology, particularly intrahepatic biliary duct dilation. This study compares the sonographic findings obtained by a radiographer/sonographer in a Basic Emergency Service (BES) using Point-of-Care Ultrasonography (POCUS) in Portugal with the sonographic findings from the same patients acquired by radiologists at a referral hospital (RH) for suspected intrahepatic biliary dilatation. Methods: Nineteen patients presenting with right upper quadrant (RUQ) pain and suspected abdominal pathology underwent sonographic screening using POCUS in the BES. Subsequently, the same patients were referred to the RH, where a radiologist performed a comprehensive ultrasound. Both examinations were compared to determine whether the findings obtained in the BES were confirmed by radiologists in the RH. Results: Cholestasis, cholangitis, lithiasis, pancreatitis, peri-ampullary lithiasis, and neoplasms were observed in association with intrahepatic biliary dilation in this study sample. All six variables showed a strong association between the BES and RH findings (Cramer’s V > 0.6; p < 0.006). A strong kappa measure of agreement between the radiographer and radiologist findings was obtained in “cholelithiasis/sludge/gallbladder acute sonographic changes” (k = 0.802; p = 0.000). A moderate kappa value was obtained for the variable “abdominal free fluid”, (k = 0.706; p = 0.001). Conclusions: In this study, all patients referred from the BES to the RH required hospitalization for treatment and additional imaging exams. Although pre-hospital screening ultrasound is not intended for definitive diagnoses, the early detection of intrahepatic biliary tract dilatation through screening sonography played a significant role in the clinical referral of patients, with a sensitivity of 94% and specificity of 75%. Full article

(This article belongs to the Section Liver)

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Gastroenterol. Insights, Volume 16, Issue 3 (September 2025) – 11 articles

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