Klinikai kérdések / Clinical questions

The old dilemma: is pancreatitis biliary or not? – The hardships of differential diagnostics of pancreatitis during pregnancy

Bősze Zsófia dr., Bor Renáta dr., Szepes Zoltán dr.

Szegedi Tudományegyetem, Belgyógyászati Klinikai Gasztroenterológiai osztály, Szeged

Pregnancy is a stand-alone risk factor of gallstone diseases. Its ratio in pregnancy can vary between 0,05-8% and 27-37% of all cases leads to surgery, without it, the ratio of the relapses can be as high as 70 percent in the population. The etiological diagnosis of acute pancreatitis can cause difficulties, and gravidity itself can be a limiting factor in the process. We would like to demonstrate the difficulties of acute biliary pancreatitis through the case of a 30-year-old 12-week pregnant woman and analyse the role of different modalities in the diagnosis, emphasizing the use of endoscopic ultrasound.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2021 | VOLUME 7, ISSUE 3

Összefoglaló közlemények / Reviews

Variceal bleeding

Vitális Zsuzsanna dr.

Debreceni Egyetem ÁOK, Belgyógyászati Intézet, Gasztroenterológiai Tanszék, Debrecen

In case of an upper gastrointestinal bleeding in cirrhotic patients, variceal bleeding must be suspected as it is much more common than bleeding from other localizations. After airway securing, the first step is the restoring of hemodynamic stabilization and preforming necessary laboratory tests, including blood group determination. Two veins should be provided through two catheters and intravenous fluid replacement should be initiated promptly. A restrictive volume resuscitation and transfusion strategy is suggested. The patient requires intensive care due to severe underlying liver disease. Vasoactive treatment (octreotide or terlipressin) and antibiotic prophylaxis should be started before endoscopy when upper gastrointestinal bleeding is detected. Gastroscopy and local hemostasis should be performed as soon as possible within the first 12 hours after admission. Endoscopical treatment (ligation, sclerotherapy, cyanoacrylate injection) should be performed even when bleeding is no longer detectable. If the hemoglobine is below 70 g/L as soon as the blood is available, the transfusion should be started, but do not increase the hemoglobin level above 90 g/L! The prophylactic antibiotic treatment is needed for at least 5 days and the intravenous vasopressor therapy for at least 3 days.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2021 | VOLUME 7, ISSUE 3

Összefoglaló közlemények / Reviews

History of artificial intelligence

Buzás György Miklós dr.1,2

1Ferencvárosi Egészségügyi Szolgáltató KKNP Kft., Gasztroenterológia, Budapest;
2MEDOC Egészségközpont, Gasztroenterológia, Budapest

Technological advances of artificial intelligence were developed in recent decades, offering an opportunity to benefit gastroenterological practice. The precursors of artificial intelligence occured in the ancient times and gradually developed over the past centuries. The current conceptions and vocabulary of artificial intelligence (deep learning, machine learning, neural networks, fuzzy logic) were developed from the 1950’s onwards. Hungarian scientists made a significant contribution to this process. Methods of artificial intelligence are applied more and more in different fields of gastroenterology (diagnosis of Helicobacter pylori infection, tumours, inflammatory bowel disease, imaging studies, drug development). Original methods of artificial intelligence are developed and applied in some Hungarian endoscopic centers.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2021 | VOLUME 7, ISSUE 3