Background:Klippel-Trenaunay syndrome(KTS)is a rare vascular malformation syndrome that can involve the gastrointestinal tract,and the characteristics of the disease are still not fully understood,and there is no clinical research data about the disease in the gastrointestinal tract in China.Aims:To summarize and analyze the clinical characteristics of Chinese patients with KTS involving the digestive tract.Methods:Relevant literature was searched using English keywords such as"Klippel-Trenaunay syndrome"and"K-T syndrome",and Chinese subject terms including"Klippel-Trenaunay syndrome"and"KTS".Each study reporting cases of KTS involving the digestive tract in China was reviewed,and clinical data of patients were collected and summarized for analysis.Results:A total of 17 Chinese patients with KTS involving the digestive tract were identified through the search.After data compilation and analysis,it was found that the majority of patients were females,with the age group of 20-29 being the most affected.60.0％of the patients presented with the typical triad of symptoms,usually affecting the right lower limb unilaterally,with cutaneous capillary malformations and limb hypertrophy as the primary clinical signs.The clinical manifestations of gastrointestinal involvement in KTS patients mainly include symptoms such as rectal bleeding,abdominal pain,and melena,with 58.9％of patients experiencing rectal bleeding within 10 years after birth,and some patients being initially misdiagnosed as having hemorrhoidal bleeding.The most commonly affected sites were the rectum and sigmoid colon,with rare cases involving the entire gastrointestinal tract.Most patients also presented with vascular abnormalities in other abdominal organs,leading to complications such as hematemesis and liver failure.Abdominal CT findings showed thickening of the affected intestinal wall and the presence of venous stones or vascular tumor lesions.Endoscopic examination revealed submucosal bluish or purplish vascular lesions and dilated vascular structures,along with disrupted mucosal vascular patterns.The majority of patients had their condition managed through conservative treatment,while severe bleeding or extensive lesions required surgery.Sclerotherapy,embolization,and other treatments have also been proven effective.Conclusions:KTS involving the digestive tract is a rare disease,commonly characterized by abdominal pain and gastrointestinal bleeding,which can be misdiagnosed as hemorrhoids.Abdominal CT or endoscopy may present specific features.Treatment mainly focuses on symptomatic management,with a subset of patients requiring surgical or interventional procedures.

Background:Klippel-Trenaunay syndrome(KTS)is a rare vascular malformation syndrome that can involve the gastrointestinal tract,and the characteristics of the disease are still not fully understood,and there is no clinical research data about the disease in the gastrointestinal tract in China.Aims:To summarize and analyze the clinical characteristics of Chinese patients with KTS involving the digestive tract.Methods:Relevant literature was searched using English keywords such as"Klippel-Trenaunay syndrome"and"K-T syndrome",and Chinese subject terms including"Klippel-Trenaunay syndrome"and"KTS".Each study reporting cases of KTS involving the digestive tract in China was reviewed,and clinical data of patients were collected and summarized for analysis.Results:A total of 17 Chinese patients with KTS involving the digestive tract were identified through the search.After data compilation and analysis,it was found that the majority of patients were females,with the age group of 20-29 being the most affected.60.0％of the patients presented with the typical triad of symptoms,usually affecting the right lower limb unilaterally,with cutaneous capillary malformations and limb hypertrophy as the primary clinical signs.The clinical manifestations of gastrointestinal involvement in KTS patients mainly include symptoms such as rectal bleeding,abdominal pain,and melena,with 58.9％of patients experiencing rectal bleeding within 10 years after birth,and some patients being initially misdiagnosed as having hemorrhoidal bleeding.The most commonly affected sites were the rectum and sigmoid colon,with rare cases involving the entire gastrointestinal tract.Most patients also presented with vascular abnormalities in other abdominal organs,leading to complications such as hematemesis and liver failure.Abdominal CT findings showed thickening of the affected intestinal wall and the presence of venous stones or vascular tumor lesions.Endoscopic examination revealed submucosal bluish or purplish vascular lesions and dilated vascular structures,along with disrupted mucosal vascular patterns.The majority of patients had their condition managed through conservative treatment,while severe bleeding or extensive lesions required surgery.Sclerotherapy,embolization,and other treatments have also been proven effective.Conclusions:KTS involving the digestive tract is a rare disease,commonly characterized by abdominal pain and gastrointestinal bleeding,which can be misdiagnosed as hemorrhoids.Abdominal CT or endoscopy may present specific features.Treatment mainly focuses on symptomatic management,with a subset of patients requiring surgical or interventional procedures.

No abstract available.
Irritable Bowel Syndrome ; Probiotics

Objective: To assess the incidence and independent risk factors for clinical anastomotic leakage (AL) in patients undergoing anterior resection (AR) or low anterior resection, (LAR) for rectal cancer. Methods: This was a retrospective case-control study of 550 patients with rectal cancer who underwent AR or LAR from April 2007 to March 2017 in Beijing Friendship Hospital, Capital Medical University. The relationship between the incidence of AL and clinicopathological manifestations was analyzed by Chi-squared test and Fisher exact test, and the independent risk factors of AL were analyzed using logistic regression analysis. AL is defined as a defect (including necrosis or abscess formation) of the intestinal wall at the anastomotic site, leading to a communication between the intra- and extra-luminal compartments. AL can be divided into three grades. Grade A anastomotic leakage results in no change in the management of patients, whereas grade B leakage requires active therapeutic intervention but is manageable without re-laparotomy. Grade C anastomotic leakage requires re-laparotomy. Results: AL was noted in 32 (5.8%) of 550 patients with rectal cancer who underwent AR or LAR, including 15 (46.9%) , 4 (12.5%) , and 13 patients (40.6%) with Grades A, B, and C, respectively. Five patients (0.9%, 5/550) died peri-operatively. AL- and non-AL-related deaths occurred in 3 (9.4%, 3/32, all cases were Grade C) and 2 patients (0.4%, 2/518) , respectively, with the two mortality rates being significant difference (P = 0.002) . Chi-squared test or Fisher exact test showed that the incidence of AL was associated with neoadjuvant chemoradiotherapy (P = 0.011) , intraoperative bleeding (≥100 ml) (χ² = 11.980, P = 0.001) , and tension-reducing suture of anastomosis (P = 0.015) . The results of logistic regression analysis showed that the independent risk factors of AL were neoadjuvant chemoradiotherapy (OR = 2.402, 95%CI: 1.004 - 5.749, P = 0.049) , intraoperative bleeding (≥100 ml) (OR = 2.971, 95%CI: 1.269 - 6.957, P = 0.012) and tension-reducing suture of anastomosis (OR = 2.304, 95%CI: 1.008 - 5.263, P = 0.048) . Conclusion The incidence of AL in patients undergoing AR for rectal cancer is 5.8%. The high-risk factors for AL are neoadjuvant chemoradiotherapy, intraoperative bleeding (≥100 ml) , and tension-reducing suture of anastomosis. Patients with these three risk factors have a high risk of AL rate, and a defunctioning stoma should be performed.

Objective To screen the prevalence of celiac disease with serologic markers in the central Chinese population,specifically in patients with chronic diarrhea-predominant irritable bowel syndrome (D-IBS).Methods A total of 282 adult patients with D-IBS were selected based on ROME Ⅲ criteria with 296 age and sex matched consecutive healthy individuals as controls.A gluten-free diet (GFD) was advised in subjects positive for IgA/IgG anti-htTG/DGP antibodies and the serologic antibodies were retested after the GFD.Results Among the 578 study subjects,five D-IBS patients (5/282,1.77％) and two healthy controls (2/296,0.68％) were positive for anti-htTG/DGP antibodies.Among the seven positive cases,one was lost to follow-up and only four were evaluated during GFD therapy for an average of 5.2 months with clinical and/or serological manifestations improved.Conclusions The prevalence of celiac disease may not be uncommon in China.Compared with the healthy population,patients with D-IBS tend to be affected more.Thus,it is significantly important to conduct routine screening for celiac disease in patients with D-IBS.