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New Insights into the Diagnosis and Treatment of Gastrointestinal Emergencies
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New Insights into the Diagnosis and Treatment of Gastrointestinal Emergencies

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (30 September 2024) | Viewed by 2985

Special Issue Editors

Dr. Bogdan Silviu Ungureanu

E-Mail Website
Guest Editor
Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
Interests: endoscopy; endoscopic ultrasound; gastrointestinal diseases; gastrointestinal malignancies; artificial intelligence
Special Issues, Collections and Topics in MDPI journals
Dr. Octavian Andronic

E-Mail Website
Guest Editor
Department of General Surgery & Innovation and eHealth Center, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
Interests: surgery; laparoscopy; trauma; artificial intelligence; gastrointestinal emergencies; gastrointestinal malignancies; surgical emergencies; innovation; biotechnology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The current Special Issue is focused on gastrointestinal emergencies from the gastroenterologist and surgeon’s perspective. Gastrointestinal emergencies comprise a spectrum of critical medical conditions affecting the digestive system, demanding prompt and specialized attention. These emergencies may manifest in various ways, from acute abdominal pain and gastrointestinal bleeding to bowel obstructions or perforations. The timely recognition and management of these gastrointestinal emergencies are crucial for preserving patient well-being and minimizing medical intervention; however, when necessary, surgical expertise is key in addressing these critical situations. Thus, early diagnosis and management may require novel approaches by distinguishing high-risk patients according to their presentations. Currently, the advent of minimally invasive approaches has revolutionized the landscape of medical interventions. By harboring techniques such as laparoscopy and endoscopy, medical practitioners may address critical gastrointestinal conditions effectively, with reduced trauma, quick recovery times, and enhanced patient outcomes. The growing integration of minimally invasive approaches as well as initial prognostic scores in gastrointestinal emergencies reflects a paradigm shift toward patient-centric care, emphasizing not only effective medical intervention but also the improved quality of life. This Special Issue will focus on original works or reviews focused on the recent status and advances in the diagnosis and management of gastrointestinal emergencies.

Dr. Bogdan Silviu Ungureanu
Dr. Octavian Andronic
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastrointestinal emergencies
  • endoscopy
  • laparoscopy
  • open surgery
  • NOTES
  • gastrointestinal bleeding
  • acute pancreatitis
  • bowel obstructions
  • gastrointestinal perforations
  • peritonitis

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

12 pages, 2788 KiB  
Article
Efficiency and Complications of Esophageal Stenting in the Management of Postoperative Fistulas
by Cristian Gelu Rosianu, Andreea Pușcașu, Petre Hoara, Dragos Predescu, Rodica Birla, Florin Achim, Vlad Codrut Strimbu, Silviu Constantinoiu, Octavian Andronic and Alexandru Constantinescu
J. Clin. Med. 2024, 13(20), 6167; https://doi.org/10.3390/jcm13206167 - 16 Oct 2024
Viewed by 1123
Abstract
Esophageal anastomotic fistula (AF) is a frequent and severe complication of an esophagectomy due to esophageal or eso-gastric junction cancer, regardless of the selected surgical technique. AF is usually treated by endoscopic stent placement. Objectives: This study aims to examine the efficacy [...] Read more.
Esophageal anastomotic fistula (AF) is a frequent and severe complication of an esophagectomy due to esophageal or eso-gastric junction cancer, regardless of the selected surgical technique. AF is usually treated by endoscopic stent placement. Objectives: This study aims to examine the efficacy of stents in the treatment of AF, analyzing the healing period and the factors that contribute to its delay. Methods: We collected data from 55 patients who underwent stent implantation for AF, and analyzed multiple variables related to patient healing time and surgical technique with two primary endpoints: post-stenting hospital stay and the time of stent usage until fistula closure. The patients were divided into three groups based on the anastomosis type (eso-gastric anastomosis, eso-gastric cervical anastomosis and eso-jejunal anastomosis) and they were compared using the primary endpoints. Results: Our findings show the differences between the three groups, with a longer hospital stay for eso-gastric anastomosis, and an extended time of fistula closure in the case of eso-gastric cervical anastomosis. We also found a significant correlation between the size of the fistula and the hospital stay (R = 0.4, p < 0.01). Regarding patients’ risk factors, our results show an extended post-stenting hospital stay for those patients that underwent preoperative radiotherapy. Conclusions: Our results offer an extended view of the efficiency, hospitalization duration and healing time for esophageal anastomotic fistula, and reveal some of the factors that interfere with its resolution. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Gastrointestinal Emergencies)
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14 pages, 1490 KiB  
Article
A New Self-Expandable Metallic Stent with Low Axial Force and a High Axial Force Zero-Border Shows a Very Low Perforation Rate in Malignant Colorectal Obstruction: A Japanese Multicenter Prospective Study
by Takashi Murakami, Hiroyuki Isayama, Satoshi Ikeda, Norihiro Hanabata, Toshiyuki Enomoto, Toshio Kuwai, Mitsunori Ushigome, Masahide Ebi, Hideo Ohtsuka, Shungo Endo, Shuji Saito, Takeshi Ohki, Ryuichi Yamamoto, Takahisa Kayahara, Satoshi Matsumoto, Yoshihiro Sasaki and Yoshihisa Saida
J. Clin. Med. 2024, 13(17), 5102; https://doi.org/10.3390/jcm13175102 - 28 Aug 2024
Cited by 2 | Viewed by 1439
Abstract
Background: Recently, there has been a significant increase in the utilization of self-expandable metallic stents (SEMSs) for treating malignant colorectal obstructions through colorectal stenting. The mechanical properties of SEMSs are usually considered to affect clinical outcomes of patients with malignant colorectal obstructions. Methods [...] Read more.
Background: Recently, there has been a significant increase in the utilization of self-expandable metallic stents (SEMSs) for treating malignant colorectal obstructions through colorectal stenting. The mechanical properties of SEMSs are usually considered to affect clinical outcomes of patients with malignant colorectal obstructions. Methods: This single-arm, prospective, multicenter study of SEMS with a lower axial force and high axial force zero-border included 200 patients with malignant colorectal obstruction. Technical and clinical success, stent patency, and adverse events associated with SEMS placement were evaluated. Results: One patient was excluded, and 199 patients were evaluated. The treatment intent was bridge-to-surgery in 129 and palliation in 70 patients. Technical and clinical success rates were 99.5% and 97.0%, respectively. The percentage of the ColoRectal Obstruction Scoring System scores of 3 or higher improved significantly from 19.2% before placement to 93.9% after placement. Clinical success was not achieved in five patients due to insufficient stent expansion in four patients and stent occlusion in one patient. Only one patient underwent emergency surgery for perforation of the proximal colon, far from where the stent was placed; the rescue procedure was not performed, despite no improvement in proximal dilatation due to insufficient stent expansion. Among the palliation cohort, 15 patients received chemotherapy, including molecular-targeted agents such as bevacizumab. There were no fatal cases related to stent placement. Conclusions: For management of malignant colorectal obstruction, this newly developed SEMS with low axial force and a high axial force zero-border showed high technical and clinical success rates, and an extremely low perforation rate (0.5%). Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Gastrointestinal Emergencies)
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