Estudio comparativo del dolor abdominal en las culturas maya Tzeltal, maya Tzotzil y maya Q ́eqchi ́y el uso de Ageratina ligustrina para su tratamiento / Comparative study of abdominal pain in the Mayan cultures Tzeltal, Maya Tzotzil and Maya Q ́eqchi´ and use of Ageratina ligustrina for the treatment

El presente estudio es una comparación del dolor abdominal producido por trastornos gastrointestinales, aliviado por Ageratina ligustrina , entre los grupos maya Tzeltal, Tzotzil y Q ́eqchi ́, el cual integró un enfoque etnomédico, etnobotánico y transcultural, comparando estudios previos con el presente trabajo de campo. Para evaluar la eficacia de Ageratina para aliviar el dolor abdominal, se realizó un inventario de las moléculas reportadas en esta especie, así como de su actividad farmacológica, a través de una revisión bibliográfica. Los resultados mostraron que la epidemiología del dolor producido por TGI, su etnobotánica y el modelo explicativo del dolor abdominal fueron similares entre grupos étnicos. Asimismo, se identificaron 27 moléculas con efectos antiinflamatorios y antinociceptivos, lo que podría explicar por qué esta especie es culturalmente importante para los pobladores maya Tzeltal, Tzotzil y Q ́eqch i ́ para el alivio del dolor abdominal, mientras que, desde el punto de vista biomédico, es una especie con potencial para inhibir el dolor visceral.

The current study is a comparison of the abdominal pain conception produced by gastrointestinal disorders, relieved by Ageratina ligustrina , among inhabitants of the Mayan Tzeltal, Tzotzil, and Q'eqchi' groups ethnomedical, ethnobotanical, and cross -cultural approaches were used to compare previous studies with the present field work. To evaluate the efficacy of A. ligustrina to relieve pain, also through a bibliographic review an inventory of the molecules present in this species was performed, as well as their pharmacological activity. The results showed that the epidemiology of pain produced by GID, its ethnobotany, and the explanatory model of abdominal pain are similar among ethnic groups. Likewise, 27 molecules with anti-inflammatory and anti-nociceptive effects were identified, which could explain why this species is culturally important for the Mayan Tzeltal, Tzotzil, and Q'eqchi' groups for the relief of abdominal pain, while, from a biomedical point of view, it is a species with potential to inhibit visceral pain.

Proton pump inhibitors and gastrointestinal symptoms among patients with COVID-19 infection.

INTRODUCTION: The administration of proton pump inhibitors (PPIs) is anticipated to elevate an individual's susceptibility to enteric infections as a result of altering the gut flora. The influence of PPIs on the clinical manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still uncertain. This study aims to investigate the impact of PPI usage on the clinical manifestation of COVID-19, namely its gastrointestinal symptoms. METHODS: This is a cross-sectional cohort study involving COVID-19 patients. Patients were interviewed using a predesigned questionnaire that asked about their demographics, clinical manifestations of COVID-19 infection, and the extent and type of PPIs in use. PPI usage was confirmed by reviewing patients' electronic medical records. The primary outcome was to establish any association between the use of PPI and the symptoms and clinical presentation of COVID-19. RESULTS: Out of a total of 254 participants, 69 (27.2%) were considered PPI users. Patients who were on PPI medications reported a significantly lower rate of myalgia (27.5% vs 51.9%; p = 0.0006) and heartburn (5.7% vs 15.6%; p = 0.03) but had a significantly higher rate of abdominal pain (27.5% vs 13.5%; p = 0.001) and diarrhoea (28.9% vs 14.5%, p = 0.02) when compared to those who were not using PPIs. Patients on PPIs were also shown to have significantly higher odds of developing diarrhoea (OR 2.0, 95% CI: 1.08 to 3.93, p = 0.02) and abdominal pain (OR 2.0, 95% CI: 1.22 to 3.93, p = 0.03), but a lower risk of developing myalgia (OR 0.5, 95% CI: 0.3 to 0.9, p = 0.02) when compared to non-PPI users. CONCLUSION: This study shows that the use of PPIs could impact COVID-19 clinical presentation toward more gastrointestinal manifestations. Further studies investigating the link between other acid suppression medications and COVID-19 manifestations and severity should be carried out.

Self-reported gastrointestinal adverse effects of non-steroidal anti-inflammatory drugs in female students with dysmenorrhoea at Makerere University: prevalence, discontinuation and associated factors. a cross sectional study.

BACKGROUND: Primary dysmenorrhoea occurs in up to 50% of menstruating females. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used therapeutic remedies for dysmenorrhoea in Uganda. However, NSAIDs are associated with a 3-5 fold increase in the risk of gastrointestinal (GI) adverse drug effects. OBJECTIVES: We aimed to determine the prevalence and associated factors of self-reported NSAID-related GI adverse effects in female students who use NSAIDs in managing dysmenorrhoea-associated pain at Makerere University. DESIGN: A cross-sectional study. SETTING: Makerere University's main campus, situated North of Kampala, Uganda. PARTICIPANTS: 314 female students pursuing an undergraduate programme at Makerere University and residing in different halls of residence and hostels. OUTCOMES: Social demographic data, menstrual history and treatment data. RESULTS: Overall, 314 valid responses were received from female students with a median age of 22 years (IQR: 18-29 years). The median age at menarche was 13 years (IQR: 9-18 years). 41% (n=129/314) of the respondents had used medication for dysmenorrhoea and 32% (n=41/129) of whom reported NSAID-associated GI adverse effects with nausea being the most frequently reported (44%, n=18/41)Factors independently associated with GI adverse effects were: age at menarche (p=0.026), duration of menstruation (p=0.030) and use of ibuprofen (p=0.005). Females taking ibuprofen for dysmenorrhoea were about four times as likely to have NSAID-associated GI adverse effects (adjusted OR 3.87, 95% CI 1.51 to 9.91) than those who did not receive ibuprofen. Logistic regression was used to determine factors associated with self-reported adverse effects of NSAIDs among the female students. A p<0.05 was considered statistically significant. CONCLUSION: We found a considerably high prevalence of NSAID-related GI adverse effects driven by factors such as age at menarche and ibuprofen use.

Long-term gastrointestinal symptoms and sleep quality sequelae in adolescents after COVID-19: a retrospective study.

Objective: To evaluate the long-term gastrointestinal (GI) symptoms and sleep quality sequelae in adolescents with COVID-19. Methods: Between June and July 2023, an online survey was done in Xiaoshan District, Hangzhou City, Zhejiang Province, China, using the GI Symptom Rating Scale (GSRS) and the Pittsburgh Sleep Quality Inventory (PSQI). Results: GI symptoms in COVID-19 patients increased by 11.86% compared to before infection, while sleep quality decreased by 10.9%. Over time, there was a significant increase in the cumulative incidence rate of GI symptoms and sleep disorders (p < 0.001). Follow-up of COVID-19 positive patients within 6 months of infection showed that GI symptoms and sleep quality began to ease starting from the first month after infection. Further analysis indicated a significant linear relationship between the severity of GI symptoms and sleep quality (R > 0.5, p < 0.001). Moreover, females, older age, and higher education were identified as risk factors influencing the long-term effects of COVID-19. Conclusion: SARS-CoV-2 affects GI symptoms and sleep quality in adolescents during both the acute phase and post-infection periods. Over time, these symptoms gradually alleviate. A significant correlation exists between GI symptoms and sleep quality.

Gastrointestinal System Symptoms, Psychological Resilience, Emotional Self-Efficacy, and Healthy Living Behaviors in Patients Scheduled for Endoscopy/Colonoscopy.

Gastrointestinal symptoms are very common worldwide. This study aimed to examine the relationship between gastrointestinal system symptoms, psychological resilience, emotional self-efficacy, and healthy living behaviors in patients. The study was conducted in a training and research hospital in Türkiye with 258 patients who had experienced gastrointestinal symptoms and were scheduled for upper endoscopy and/or colonoscopy. The data were obtained by using an information form, the Brief Resilience Scale, the Emotional Self-Efficacy Scale, the Healthy Lifestyle Behaviors Scale, and the Gastrointestinal Symptom Rating Scale. A statistically positive and significant relationship was found between the Emotional Self-Efficacy Scale and the Healthy Lifestyle Behaviors Scale (r = 0.376; p < .05). It was determined that there was a statistically significant negative relationship between the mean Brief Resilience Scale and the Gastrointestinal Symptom Rating Scale scores (r = -0.150; p < .05). In addition, a positive and significant relationship was found between the mean Brief Resilience Scale and the Emotional Self-Efficacy Scale scores (r = 0.374; p < .05). Psychological factors and healthy living behaviors thus clearly affect gastrointestinal system symptoms. For this reason, it is thought that planning interventions to teach self-management through healthy living behaviors and promoting psychological resilience may reduce gastrointestinal system symptoms.

High Prevalence and Risk Factors of Functional Gastrointestinal Disorders Among University Students in South Korea.

Functional gastrointestinal disorders are common and have high prevalence in young adults. This study aimed to identify the prevalence and risk factors of functional gastrointestinal disorders in university students. A cross-sectional study was conducted in January 2021 at two universities in a South Korean city and included 493 participants. The Rome IV criteria (for functional dyspepsia and irritable bowel syndrome) and the Korean gastroesophageal reflux disease questionnaire (for gastroesophageal reflux disease) were used to define each disease. Data were analyzed using descriptive statistics and multivariate logistic regression. Gastroesophageal reflux disease, functional dyspepsia, and irritable bowel syndrome prevalence was 18.5%, 7.5%, and 6.5%, respectively, in university students. In multivariate analysis, school year (fourth) (odds ratio [95% confidence interval] = 2.27 [0.25, 0.78]), underlying disease (odds ratio [95% confidence interval] = 2.92 [1.42, 6.04]), physical activity less than once weekly (odds ratio [95% confidence interval] = 4.84 [1.04, 22.45]), very irregular meals (odds ratio [95% confidence interval] = 4.02 [1.54, 10.49]), overeating more than 5 times weekly (odds ratio [95% confidence interval] = 3.37 [1.19, 9.56]), and academic stress (odds ratio [95% confidence interval] = 1.02 [1.01, 1.03]) were risk factors for functional gastrointestinal disorders. Our findings indicate that a comprehensive management program focusing on eating habits and psychological factors is needed to reduce the prevalence of functional gastrointestinal disorders in university students.

Evaluation of the impact of overlapping upper gastrointestinal symptoms on the clinical characteristics of patients with functional constipation, along with risk factor analysis.

OBJECTIVES: Functional constipation (FC), a common functional gastrointestinal disorder, is usually overlapping with upper gastrointestinal symptoms (UGS). We aimed to explore the clinical characteristics of patients with FC overlapping UGS along with the related risk factors. METHODS: The differences in the severity of constipation symptoms, psychological state, quality of life (QoL), anorectal motility and perception function, autonomic function, and the effect of biofeedback therapy (BFT) among patients with FC in different groups were analyzed, along with the risk factors of overlapping UGS. RESULTS: Compared with patients with FC alone, those with FC overlapping UGS had higher scores in the Patient Assessment of Constipation Symptoms and Self-Rating Anxiety Scale and lower scores in the Short Form-36 health survey (P < 0.05). Patients with FC overlapping UGS also had lower rectal propulsion, more negative autonomic nervous function, and worse BFT efficacy (P < 0.05). Overlapping UGS, especially overlapping functional dyspepsia, considerably affected the severity of FC. Logistic regression model showed that age, body mass index (BMI), anxiety, exercise, and sleep quality were independent factors influencing overlapping UGS in patients with FC. CONCLUSIONS: Overlapping UGS reduces the physical and mental health and the QoL of patients with FC. It also increases the difficulty in the treatment of FC. Patient's age, BMI, anxiety, physical exercise, and sleep quality might be predictors for FC overlapping UGS.

Genome-wide cross-disease analyses highlight causality and shared biological pathways of type 2 diabetes with gastrointestinal disorders.

Studies suggest links between diabetes and gastrointestinal (GI) traits; however, their underlying biological mechanisms remain unclear. Here, we comprehensively assess the genetic relationship between type 2 diabetes (T2D) and GI disorders. Our study demonstrates a significant positive global genetic correlation of T2D with peptic ulcer disease (PUD), irritable bowel syndrome (IBS), gastritis-duodenitis, gastroesophageal reflux disease (GERD), and diverticular disease, but not inflammatory bowel disease (IBD). We identify several positive local genetic correlations (negative for T2D - IBD) contributing to T2D's relationship with GI disorders. Univariable and multivariable Mendelian randomisation analyses suggest causal effects of T2D on PUD and gastritis-duodenitis and bidirectionally with GERD. Gene-based analyses reveal a gene-level genetic overlap between T2D and GI disorders and identify several shared genes reaching genome-wide significance. Pathway-based study implicates leptin (T2D - IBD), thyroid, interferon, and notch signalling (T2D - IBS), abnormal circulating calcium (T2D - PUD), cardiovascular, viral, proinflammatory and (auto)immune-mediated mechanisms in T2D and GI disorders. These findings support a risk-increasing genetic overlap between T2D and GI disorders (except IBD), implicate shared biological pathways with putative causality for certain T2D - GI pairs, and identify targets for further investigation.

Evolutionary dynamics of canine kobuvirus in Vietnam and Thailand reveal the evidence of viral ability to evade host immunity.

Canine kobuvirus (CaKoV) is a pathogen associated with canine gastrointestinal disease (GID). This study examined 327 rectal swabs (RS), including 113 from Vietnam (46 healthy, 67 with GID) and 214 from Thailand (107 healthy and 107 with GID). CaKoV was detected in both countries, with prevalences of 28.3% (33/113) in Vietnam and 7.9% (17/214) in Thailand. Additionally, CaKoV was found in both dogs with diarrhea and healthy dogs. CaKoV was mainly found in puppies under six months of age (30.8%). Co-detection with other canine viruses were also observed. The complete coding sequence (CDS) of nine Vietnamese and four Thai CaKoV strains were characterized. Phylogenetic analysis revealed a close genetic relationship between Vietnamese and Thai CaKoV strains, which were related to the Chinese strains. CDS analysis indicated a distinct lineage for two Vietnamese CaKoV strains. Selective pressure analysis on the viral capsid (VP1) region showed negative selection, with potential positive selection sites on B-cell epitopes. This study, the first of its kind in Vietnam, provides insights into CaKoV prevalence in dogs of different ages and healthy statuses, updates CaKoV occurrence in Thailand, and sheds light on its molecular characteristics and immune evasion strategies.

The underlying mechanism, efficiency, and safety of manual therapy for functional gastrointestinal disorders: A narrative review.

INTRODUCTION: Functional gastrointestinal disorders encompass a range of conditions resulting from complicated gut-brain interactions, which can negatively impact sufferers' lives. They are prevalent in clinical practice and the community, with a lifetime prevalence of almost 40 % worldwide. The challenge in diagnosing these disorders lies in the non-specificity of symptoms and the absence of reliable biomarkers. The existing literature suggests a multidisciplinary approach, including cognitive-behavioral therapy, dietary changes, psychotropic drug therapy, and improving gastrointestinal motility. Manual therapy applied to the abdomen and adjacent areas can potentially enhance gastrointestinal motility. OBJECTIVES: This review aims to examine the types of manual interventions, their mechanisms, efficiency, and safety in managing functional disorders of the digestive system. METHODS: We searched PubMed and Google Scholar in English from May 2022 to February 2023 with no date restriction. We prioritized systematic reviews, meta-analyses, and clinical trials and did not exclude any data sources. RESULTS AND CONCLUSION: s: Initial evidence suggests that manual interventions on the abdomen and adjacent areas are effective in managing functional gastrointestinal disorders, with no reported adverse events and relatively low costs. However, further studies with rigorous scientific methodology are needed to understand better the unknown dimensions influencing the outcomes observed with abdominal massage and its positive impact on patients. Manual abdominal techniques are a promising therapy option for functional gastrointestinal disorders, and their efficacy, safety, and cost-effectiveness should be further explored.

A retrieval-augmented chatbot based on GPT-4 provides appropriate differential diagnosis in gastrointestinal radiology: a proof of concept study.

BACKGROUND: We investigated the potential of an imaging-aware GPT-4-based chatbot in providing diagnoses based on imaging descriptions of abdominal pathologies. METHODS: Utilizing zero-shot learning via the LlamaIndex framework, GPT-4 was enhanced using the 96 documents from the Radiographics Top 10 Reading List on gastrointestinal imaging, creating a gastrointestinal imaging-aware chatbot (GIA-CB). To assess its diagnostic capability, 50 cases on a variety of abdominal pathologies were created, comprising radiological findings in fluoroscopy, MRI, and CT. We compared the GIA-CB to the generic GPT-4 chatbot (g-CB) in providing the primary and 2 additional differential diagnoses, using interpretations from senior-level radiologists as ground truth. The trustworthiness of the GIA-CB was evaluated by investigating the source documents as provided by the knowledge-retrieval mechanism. Mann-Whitney U test was employed. RESULTS: The GIA-CB demonstrated a high capability to identify the most appropriate differential diagnosis in 39/50 cases (78%), significantly surpassing the g-CB in 27/50 cases (54%) (p = 0.006). Notably, the GIA-CB offered the primary differential in the top 3 differential diagnoses in 45/50 cases (90%) versus g-CB with 37/50 cases (74%) (p = 0.022) and always with appropriate explanations. The median response time was 29.8 s for GIA-CB and 15.7 s for g-CB, and the mean cost per case was $0.15 and $0.02, respectively. CONCLUSIONS: The GIA-CB not only provided an accurate diagnosis for gastrointestinal pathologies, but also direct access to source documents, providing insight into the decision-making process, a step towards trustworthy and explainable AI. Integrating context-specific data into AI models can support evidence-based clinical decision-making. RELEVANCE STATEMENT: A context-aware GPT-4 chatbot demonstrates high accuracy in providing differential diagnoses based on imaging descriptions, surpassing the generic GPT-4. It provided formulated rationale and source excerpts supporting the diagnoses, thus enhancing trustworthy decision-support. KEY POINTS: • Knowledge retrieval enhances differential diagnoses in a gastrointestinal imaging-aware chatbot (GIA-CB). • GIA-CB outperformed the generic counterpart, providing formulated rationale and source excerpts. • GIA-CB has the potential to pave the way for AI-assisted decision support systems.

Chief complaints and computed tomography results in the emergency department: a three-year retrospective cohort study.

BACKGROUND: Computed tomography (CT) is frequently performed in the patients who admitted to the emergency department (ED), discharged but returned to ED within 72 h. It is unknown whether the main complaints of patients assist physicians to use CT effectively. This study aimed to find the association between chief complaints and the CT results. METHODS: This three-year retrospective cohort study was conducted in the ED of a tertiary medical center. Adult patients who returned to the ED after the index visit were included from 2019 to 2021. Demographics, pre-existing diseases, chief complaints, and CT region were recorded by independent ED physicians. A logistic regression model with an odds ratio (OR) and 95% confidence interval (CI) was used to determine the relationship between chief complaints and positive CT results. RESULTS: In total, 7,699 patients revisited ED after the index visit; 1,202 (15.6%) received CT. The top chief complaints in patients who received CT were abdominal pain, dizziness, and muscle weakness. Patients with abdominal pain or gastrointestinal symptoms had a significantly higher rate of positive abdominopelvic CT than those without it (OR 2.83, 95% CI 1.98-4.05, p < 0.001), while the central nervous system and cardiopulmonary chief complaints were not associated (or negatively associated) with new positive CT findings. CONCLUSION: Chief complaints of patients on revisit to the ED are associated with different yields of new findings when CT scans of the chest, abdomen and head are performed. Physicians should consider these differential likelihoods of new positive findings based on these data.

The prevalence and severity of upper gastrointestinal complications among patients with chronic diseases: a cross-sectional study from Palestine.

BACKGROUND: Many old people have at least one chronic disease. As a result, multiple drugs should be used. Gastrointestinal complications may occur because of the harmful effects of these chronic drugs on the stomach. The study aimed to assess the prevalence of upper gastrointestinal complications in patients taking chronic medications, the severity of these symptoms, and whether they take any gastro-protective drugs or not. METHODOLOGY: This was a cross-sectional study through face-to-face questionnaires from internal outpatient clinics at a specialized hospital. Patients with chronic diseases who were taking at least one chronic medication were included in the study. Data Collection Form was used to gather information. The Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) was used to evaluate the severity of the upper gastrointestinal symptoms. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 21. RESULTS: A total of 400 patients with chronic diseases and using multiple medications were included. Among them, 53.8% were females and 56% were married, 58.5% were unemployed, 70% were not smokers, the mean age was 54.7 ± 17.5 years. The most common comorbid diseases among the patients were diabetes, hypertension, and arthritis, with percentages of 44.3%, 38%, and 27.3%, respectively. The mean number of chronic medications used was 3.36 ± 1.6 with a range of 1 to 9. The most commonly used was aspirin with a percentage of 50%, followed by atorvastatin, bisoprolol, and insulin with percentages of 29.5%, 25%, and 20.3%, respectively. Among the 400 participants, 362 (90.5%) suffered from upper gastrointestinal side effects like indigestion (65.8%), heartburn (78.3%), nausea (48.8%), and regurgitation (52.0%). Based on SF-LDQ scoring, of the 400 respondents, 235(58.8%), 109(27.3%) and 18(4.5%) suffered from mild, moderate and severe dyspepsia, respectively. A high percentage 325 (81.3%) of participants were prescribed gastro-protective medications. Proton pump inhibitors were the most prescribed group in 209 (52.3%) patients. Dyspepsia was significantly associated with older age (p-value = 0.001), being educated (p-value = 0.031), not being single (p-value < 0.001), having health insurance (p-value = 0.021), being a smoker (p-value = 0.003), and using ≥ 5 medications (p-value < 0.001). CONCLUSION: Upper gastrointestinal complications among patients with chronic diseases were very common. Fortunately, the symptoms were mild in most cases. The risk increased with age and using a higher number of medications. It is important to review patients' medications and avoid overuse of them, in addition to use gastro-protective agents when needed.

[The new guideline for gastrointestinal infections]. / Die neue Leitlinie für gastrointestinale Infektionen.

Gastrointestinal infections are still responsible for around 60% of the infectious diseases that must be reported in Germany and are probably among the most common gastroenterological diseases. The main therapy for gastrointestinal infections remains oral fluid replacement. The recommendations for Clostridioides difficile infections (CDI) have been adapted according to the current data and based on international guidelines; vancomycin or, especially if there is an increased risk of recurrence, fidaxomicin should now be used primarily in CDI. In the case of febrile diarrhea and/or bloody diarrhea, malaria diagnosis should be carried out immediately.

Relationship between gastrointestinal symptoms and COVID-19 infection in the pediatric population: a scoping review.

OBJECTIVE: To map the evidence in the literature about the relationship between gastrointestinal symptoms and COVID-19 in the pediatric population. METHOD: This is a scoping review following the recommendations of the Joanna Briggs Institute and PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. The search was carried out on the following bases: Embase, Google Scholar, PubMed, Scopus, LILACS, CINAHL, Scielo, Web of Science and Virtual Health Library Portal, between July and August 2023. Original studies available in full, in any language, were included. RESULTS: Ten studies were chosen that pointed to three premises: (1) the ACE2 receptor is found in the epithelial cells of the gastrointestinal tract; (2) gastrointestinal symptoms are mediated by stress and infection is justified by the gut-brain axis; (3) it develops the process of Multisystem Inflammatory Syndrome in children, affecting the gastrointestinal tract. CONCLUSION: The synthesis of evidence provided three assumptions which guide the origin of gastrointestinal symptoms. The identification of gastrointestinal symptoms in children affected by COVID-19 can assist in the clinical approach and management of care and treatments.

The contribution of EUS to the management of endoscopic and surgical complications.

Endoscopic Ultrasound (EUS) stands as a remarkable innovation in the realm of gastroenterology and its allied disciplines. EUS has evolved to such an extent that it now assumes a pivotal role in both diagnosis and therapeutics. In addition, it has developed as a tool which is also capable of addressing complications arising from endoscopic and surgical procedures. This minimally invasive technique combines endoscopy with high-frequency ultrasound, facilitating, high-resolution images of the gastrointestinal tract and adjacent structures. Complications within the gastrointestinal tract, whether stemming from endoscopic or surgical procedures, frequently arise due to disruption in the integrity of the gastrointestinal tract wall. While these complications are usually promptly detected, there are instances where their onset is delayed. EUS plays a dual role in the management of these complications. Firstly, in its ability to assess and increasingly to definitively manage complications through drainage procedures. It is increasingly employed to manage post-surgical collections, abscesses biliary strictures and bleeding. Its high-resolution imaging capability allows precise real-time visualisation of these complications.