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Case report of "unusual" foreign bodies in the oesophagus

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Case report of "unusual" foreign bodies in the oesophagus

Katarina Karlovic 1

1 KBC Rijeka, Rijeka, Croatia

Event

UEG Week Vienna 2024

Topics

Nurses

Session

Abstracts II: Patient care and endoscopic techniques

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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Diagnosis and management of pancreatic insufficiency

Juan Enrique Dominguez-Munoz 1

1 University Hospital of Santiago de Compostela - Gastroenterology and Hepatology, University Hospital, Santiago de Compostela, Spain

Event

UEG Week Berlin 2025

Topics

Immunology Pancreas

Session

Chronic pancreatitis and rare etiologies

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

UEG Poster

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Introduction

Although there is growing interest on prognostic and therapeutic value of KRAS mutations detection in pancreatic ductal adenocarcinoma (PDAC) patients’, the limited availability of sensitive, cost-effective and efficient molecular technologies has restricted its use. We present the fast single-step methodology utilizing amplification refractory mutation system (ARMS) coupled with high-resolution melting analysis (HRMA) to evaluate KRAS mutations and their prognostic value.

Aims & Methods

This is a prospective bicentric cohort study including PDAC patients with tumor samples collected at diagnosis. Codon-12/13 KRAS mutations were tested by Sanger Sequencing (SS) and the most frequent mutations were tested by ARMS/HRMA (G12D, G12V, G12R and G12C). Primary endpoint was the frequency of KRAS mutations by both techniques and their concordance. Secondary endpoints were the association of KRAS mutations and progression free survival (PFS) and overall survival (OS).

Results

83 patients, 57% male, with median-age at diagnosis of 70 (IQR 63-75) years-old, 55% submitted to upfront-surgery, 45% to palliative-chemotherapy or best-supportive care were included. SS detected KRAS mutations in 67% of tumor samples (G12D=47%, G12V=30%, G12R=13%, G12C=4%, G13V=4%, G12A=2%) and ARMS/HRMA in 82% (G12D=48%, G12V=35%, G12R=10%, G12C=2%, G12V/G12D=3%, G12D/G12C=2%) with a moderate concordance in mutation detection (kappa=0.517, p<0.001). Operated patients with G12C-mutated tumors had lower PFS (0 vs 8.5 months, HR=14.08 95%CI 1.435-138.207, p=0.023) and OS (0 vs 10 months, HR=11.49 95%CI 1.190-110.988, p=0.035) compared with wildtype tumors. No other differences were found in PFS and OS between KRAS-mutated and wildtype patients.

Conclusion

ARMS/HRMA appears to offer greater accuracy than SS in evaluating KRAS mutations in PDAC tumor samples, with the added benefits of speed and reduced costs. The presence of the G12C mutation was associated to lower OS and PFS, with early relapse after surgery. As such and with the recent emergence of drugs targeting G12C mutation (adagrasib), even resectable tumors might have indication for medical therapy, opening new avenues for personalized therapy in PDAC patients.

A NEW TOOL FOR MOLECULAR PROFILING OF KRAS MUTATIONS IN TUMOR SAMPLES FROM PATIENTS WITH PANCREATIC DUCTAL ADENOCARCINOMA – BRINGING HOPE TO ENHANCE TREATMENT STRATEGIES

Ana Catarina Bravo 1, Bárbara Morão 1, André Luz 2, Beatriz Oliveira 2, Rúben Dourado 2, Beatriz Costa 2, Susana Saraiva 1, Catarina Andrade Fidalgo 1, Luís Mascarenhas Lemos 3, Maria Pia Costa Santos 4, Rui Maio 5, Pedro Viana Baptista 2, Alexandra Fernandes 2, Marilia Lopes Cravo 6

1 Hospital Beatriz Ângelo, Loures, Portugal

2 Associate Laboratory i4HB - Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, Caparica, Portugal|||UCIBIO – Applied Molecular Biosciences Unit, Department of Life Sciences, NOVA School of Science and Techn

3 Hospital da Luz, Lisbon, Portugal|||NOVA Medical School, Universidade de Lisboa, Lisboa, Portugal|||Faculdade de Medicina da Universidade Católica Portuguesa, Lisboa, Portugal

4 Hospital do Divino Espírito Santo, Ponta Delgada, Portugal

5 Hospital Beatriz Ângelo, Loures, Portugal|||Hospital da Luz, Lisbon, Portugal

6 Hospital da Luz, Lisbon, Portugal

Conference

UEG Week Vienna 2024

Topics

Pancreas

Submission format

Abstract

Session

Molecular and clinical therapies in HPB (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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Summary: Liver and pregnancy - Beware of dangerous liaisons

Christophe Moreno 1

1 Hôpital Erasme (gastro) - Hôpital Erasme (gastro); Maransart/BE, Brussels, Belgium

Event

UEG Postgraduate Teaching Programme Berlin 2025

Topics

Hepatobiliary Paediatrics

Session

Liver and pregnancy: Beware of dangerous liaisons

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Introduction

With the obesity epidemic, the number of related health conditions have also markedly increased. As a result, the prevalence of metabolic syndrome (MS) reached 25% in western countries. In the severe form of acute pancreatitis (AP), mortality rate may be as high as 50%. Earlier studies associated the elements of MS with more complications, increased severity and mortality in AP. The aim of our meta-analysis was to identify the most important risk factors by investigating the individual and synergistic effect of MS factors on AP outcome.

Aims & Methods

Our systematic search was performed in three databases (MEDLINE, Embase and CENTRAL) from inception to 1 November 2023. Articles were selected according to predefined eligibility criteria. We investigated the effect of four MS factors: obesity, hypertension, diabetes mellitus and hypertriglyceridemia on AP outcome. We calculated pooled odds ratios (OR) with 95% confidence intervals (CIs). Risk of bias assessment was carried out with the Quality in Prognostic Studies (QUIPS) tool. The protocol was registered in PROSPERO under number CRD42023471092.

Results

We identified 15,904 unique records, and after the selection process, 103 studies were included in our analysis. Based on the results of four articles with a total sample size of 137,000, patients with MS are more likely to have moderately severe and severe, rather than mild AP (OR=1.687, CI:0.593-4.803). The odds of developing severe AP is almost 40% increased in the MS patient group (OR=1.398, CI:0.918-2.129). The risk of mortality is also increased in the group with MS (OR=1.307, CI:0.240-7.102). When analyzed individually, hypertension was a statistically significant predictor of both mortality (OR=2.564, CI:1.392-4.723) and disease severity (OR=1.792, CI:1.399-2.296) in AP.

Conclusion

MS and hypertension individually worsen the outcome of AP and may serve as a clinical predictor of severity and mortality.

METABOLIC SYNDROME AND HYPERTENSION INDIVIDUALLY WORSEN THE OUTCOME OF ACUTE PANCREATITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Dalma Dobszai 1, Mahmoud Obediat 2, Eszter Ágnes Szalai 3, Ádám Zolcsák 2, Luca Havelda 3, Renáta Papp 3, Alim Choi 2, Bettina Csilla Budai 3, Dominika Csajbók 2, Andrea Szentesi 4, Peter Hegyi 5

1 Semmelweis University, Budapest, Hungary|||University of Pécs Medical School, Pécs, Hungary

2 Semmelweis University, Budapest, Hungary

3 Semmelweis University, Budapest, Hungary|||Semmelweis University, Budapest, Hungary

4 University of Pécs, Pécs, Hungary|||Semmelweis University, Budapest, Hungary

5 Semmelweis University, Budapest, Hungary|||Semmelweis University, Budapest, Hungary|||University of Pécs, Pécs, Hungary|||University of Szeged, Szeged, Hungary

Conference

UEG Week Vienna 2024

Topics

Pancreas

Submission format

Abstract

Session

Acute pancreatitis (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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Pitfalls in differential diagnosis and aetiology of chronic pancreatitis

Georg Beyer 1

1 University Hospital LMU Munich, München, Germany

Event

UEG Postgraduate Teaching Programme Vienna 2024

Topics

Education & Training Mechanisms & Personalised Medicine Pancreas Primary Care

Session

A personalised approach to chronic pancreatitis

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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EUS-GUIDED GALL BLADDER DRAINAGE WITH ELECTROCAUTERY-ENHANCED LUMEN-APPOSING METAL STENTS: A UK AND IRELAND MULTI-CENTRE COLLABORATION

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Introduction

EUS-guided gall bladder drainage (EUS-GBD) with an electrocautery-enhanced lumen-apposing metal stent (EC-LAMS) is emerging as a method of establishing gall bladder drainage in patients who lack fitness for surgery¹.
The aim of the study was to assess the efficacy, safety and long-term outcomes in patients who underwent EUS-GBD with an EC-LAMS.

Aims & Methods

A retrospective review of consecutive patients who underwent EUS-GBD with EC-LAMS at 11 tertiary institutions across the United Kingdom and Ireland between January 2016 and December 2022 was undertaken.

Results

Sixty two patients (71.0% female; n=44) with a median age of 74.6 years (range 33-95 years) were included. The predominant approach was transduodenal (59.7%; n=37), while the most common indication was non-malignant cholecystitis (56.5%; n=35).
The mean follow-up period was 2.1 years (range 0.04-6.9 years); 72.6% (n=45) were alive at the end of the follow-up period.
Technical success, defined as successful gall bladder access followed by adequate transmural EC-LAMS deployment, was achieved in 95.2% (n=59). Clinical success, defined as resolution of clinical parameters of acute cholecystitis (as per Tokyo 2018 diagnostic criteria) within 96 hours was achieved in 94.7% (n=54).
The 30-day adverse event rate was 4.8% (n=3), with 3.2% (n=2) experiencing a severe/fatal event (as per ASGE lexicon). A further adverse event (1 severe) occurred in 14.8% (n=4) of those who were followed up for a year and in 7.1% (n=1) of those who were followed up for two years.
Of those with benign disease, the EC-LAMS was removed in 15.0% (n=3) of cases who were followed up for at least one year. This was associated with an adverse event (recurrent cholecystitis) in only one case.

Conclusion

EUS-GBD with EC-LAMS at tertiary institutions is a highly effective and relatively safe technique in patients who are not fit for surgery. Technical failures or adverse events can usually be managed conservatively or with endoscopic therapy.

References

References:

Luo X, Sharaiha R, Teoh AYB. Endoscopic Management of Acute Cholecystitis. Gastrointest Endosc Clin N Am. 2022 Jul;32(3):527-543.

EUS-GUIDED GALL BLADDER DRAINAGE WITH ELECTROCAUTERY-ENHANCED LUMEN-APPOSING METAL STENTS: A UK AND IRELAND MULTI-CENTRE COLLABORATION

James Gauci 1, Wafaa Ahmed 2, Bharat Paranandi 2, Wei On 2, Matthew Huggett 2

1 MidYorkshire Hospitals NHS Trust, Wakefield, United Kingdom

2 Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom

Event

UEG Week Copenhagen 2023

Topics

Endoscopy Hepatobiliary

Submission format

Abstract

Session

Hepatobiliary endoscopy: Old procedure, new approach

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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