1.Utility of narrow-band imaging with or without dual focus magnification in neoplastic prediction of small colorectal polyps: a Vietnamese experience
Tien Manh HUYNH ; Quang Dinh LE ; Nhan Quang LE ; Huy Minh LE ; Duc Trong QUACH
Clinical Endoscopy 2023;56(4):479-489
Background/Aims:
Accurate neoplastic prediction can significantly decrease costs associated with pathology and unnecessary colorectal polypectomies. Narrow band imaging (NBI) and dual-focus (DF) mode are promising emerging optical technologies for recognizing neoplastic features of colorectal polyps digitally. This study aimed to clarify the clinical usefulness of NBI with and without DF assistance in the neoplastic prediction of small colorectal polyps (<10 mm).
Methods:
This cross-sectional study included 530 small colorectal polyps from 343 consecutive patients who underwent colonoscopy at the University Medical Center from September 2020 to May 2021. Each polyp was endoscopically diagnosed in three successive steps using white-light endoscopy (WLE), NBI, and NBI-DF and retrieved for histopathological assessment. The diagnostic accuracy of each modality was evaluated with reference to histopathology.
Results:
There were 295 neoplastic polyps and 235 non-neoplastic polyps. The overall accuracies of WLE, WLE+NBI, and WLE+NBI+NBI-DF in the neoplastic prediction of colorectal polyps were 70.8%, 87.4%, and 90.8%, respectively (p<0.001). The accuracy of WLE+NBI+NBI-DF was significantly higher than that of WLE+NBI in the polyp size ≤5 mm subgroup (87.3% vs. 90.1%, p<0.001).
Conclusions
NBI improved the real-time neoplastic prediction of small colorectal polyps. The DF mode was especially useful in polyps ≤5 mm in size.
2.Ischemic Colitis Presented as Pseudomembranous Colitis: An Untypical Case from Vietnam
Tien Manh HUYNH ; Quang Dinh LE ; Khanh Lan NGUYEN BUI ; Minh Quang HUYNH BUI ; Cong Minh HONG VO ; Duc Trong QUACH
The Korean Journal of Gastroenterology 2022;80(2):93-98
Ischemic colitis (IC) is an underreported chronic disease characterized by the hypoperfusion of the bowel mucosa. The diagnosis and treatment may be challenging because its clinical course resembles other colitis or even colorectal malignancies. This paper reports an untypical case to underline the diversity of IC manifestation. A 68-year-old man with several comorbidities was admitted because of abdominal pain with a 6-month duration and a mass in the left lower quadrant. Colonoscopy revealed erosive pseudomembranous colitis narrowed colon segments with ulcerated mucosa mimicking colorectal cancer and inflammatory bowel disease. The stool cultures and Clostridium difficile toxin tests were negative. After the failure of conservative therapy, the Hartmann procedure with temporary ileostomy was performed uneventfully. The histological results of the surgical specimens revealed IC with focal pseudomembranous areas.
3.Rare Complication of Strongyloidiasis in Vietnam: A Case of Venous Thromboembolism and Duodenal Obstruction
Tien Huynh MANH ; Khanh Quoc Le TRAN ; Phat Tan HO ; Man Minh VO ; Thong Quang PHAM ; Thong Duy VO
The Korean Journal of Gastroenterology 2023;81(6):270-275
Strongyloidiasis, a chronic helminth infection caused by the parasitic nematode Strongyloides stercoralis, has various clinical manifestations. Although rare, duodenal obstructions and venous thromboembolism are possible complications of strongyloidiasis.This paper presents the case of a 47-year-old Vietnamese male with a history of right lower limb edema, anorexia, nausea, vomiting, diarrhea, and abdominal discomfort lasting for four months. Venous Doppler ultrasound detected a thrombus in the right femoral vein, while an abdominal CT scan revealed a mass lesion suggestive of a lower bile duct tumor. Esophageogastroduodenoscopy showed a friable duodenal cap mucosa with multiple ulcers and edematous mucosa of the second part of the duodenum that caused a partial lumen obstruction. The final histological examination of the biopsy specimen revealed chronic duodenitis with larvae consistent with Strongyloides stercoralis. The patient was treated with Ivermectin for two weeks and anticoagulation therapy for three months. After treatment and a six-month follow-up, the patient's gastrointestinal symptoms and leg swelling resolved completely. This is the first documented case of a patient in Vietnam with strongyloidiasis who presented with venous thromboembolism and duodenal obstruction. (Korean J Gastroenterol 2023;81:270-275)
4.Atypical Toxocara canis-Induced Hepatic Visceral Larva Migrans: Diagnostic Challenges and Literature Review
Tien Manh HUYNH ; Khanh Quoc Le TRAN ; Trung Hoang DINH ; Man Minh VO ; Thong Quang PHAM ; Thong Duy VO
The Korean Journal of Gastroenterology 2024;83(6):247-252
Toxocariasis, a zoonotic infection transmitted by Toxocara canis (from dogs) and Toxocara cati (from cats) larvae, poses rare but severe risks to humans. We present a case of hepatic visceral larva migrans (VLM) caused by Toxocara canis in a 21-year-old male with a history of close contact with a pet dog. Initial symptoms and imaging findings mimicked a pyogenic liver abscess. The initial laboratory investigations revealed neutrophilia and elevated levels of IgE. Despite broad-spectrum antibiotics, persistent fever prompted further investigation. Subsequent serological testing for Toxocara antibodies and histopathological analysis of liver tissue demonstrating eosinophil infiltrates and Charcot-Leyden crystals led to a confirmed diagnosis of a liver abscess caused by Toxocara canis. Serological testing for Toxocara antibodies and histopathological analysis of liver tissue confirmed a Toxocara canis-induced liver abscess. Albendazole treatment yielded significant clinical improvement. This case highlights the necessity of considering toxocariasis in liver abscess differentials, particularly in high-seroprevalence regions like Vietnam. Relying solely on serological tests may be insufficient, emphasizing the need for corroborative evidence, including invasive procedures like liver biopsy, for accurate hepatic toxocariasis diagnosis.
5.Blood pressure screening results in adults in Thua Thien Hue province through the program “May Measurement Month” 2022 of the International Society of Hypertension
Manh Tri NGO ; Thi Hoai Thuong TRAN ; Thanh Thien LE ; Tan Hung HUYNH ; Anh Tuyet NGUYEN ; Thi Khanh Van NGUYEN ; Thi Minh Luong TRAN ; Anh Tien HOANG ; Van Minh HUYNH
Hue Journal of Medicine and Pharmacy 2023;13(7):15-22
Background: Hypertension is a common disease in adults, also the leading cause of cardiovascular disease and premature death worldwide. The prevalence of hypertension has increased, especially in low- and middle-income countries. Therefore, hypertension screening is important to provide the basis and evidence for the development of timely intervention policies and programs. The objective of the “May Measurement Month” 2022 program is to investigate the prevalence of hypertension, drug treatment and blood pressure control in people in Thua Thien Hue province and to assess the risk factors surrounding hypertension. Subjects and Methods: This cross–sectional study collected data from volunteer adults (≥ 18 years old) in Thua Thien Hue province from 7/2022 to 8/2022. Sitting blood pressure had been measured in triplicate according to standardized specified methods of the International Society of Hypertension. Results: Average age 54.07 ± 18.17, there were 627 people (23.4%) with hypertension at the time of screening, 245 of which (39.1%) had never been diagnosed with hypertension before screening at the time. 724 people were on treatment with 1 or more types of drug, however, there were 337 people (46.5%) having their blood pressure not controlled. The statistics showed that 84.9% of volunteers were using at least 1 drug to treat hypertension. Related factors of hypertension are age, sex, overweight/obesity status, smoking, medical history of diabetes and medical history of COVID-19. The rate of subjects who had history of COVID-19 was 36.4%, including 31.6% of hypertension patients. Conclusion: The hypertension percentage of Thua Thien Hue population is still high and the rate of blood pressure control is still limited. There is a relationship between hypertension proportion and history of COVID-19. It is necessary to publish timely intervention measures to reduce the rate of hypertension and its risks to people.