A case report of Cronkhite-Canada syndrome first encounterd at a hospital in northern Vietnam.

Introduction and importance: Cronkhite-Canada syndrome (CCS) is an extremely rare non-inherited syndrome first described in 1955 with only about 500 more cases reported so far. Since the aetiology of the disease remains unknown, there were no specific treatments in consensus. In many countries, CCS is a completely new condition that may confuse physicians at first encounter. Lessons should be learned from these cases by gastrointestinal specialists to be aware of this condition in any circumstances. Case presentation: The authors reported a case study of a 45-year-old Vietnamese male with CCS diagnosis, which encountered at our centre for the first time. Clinical discussion: The definitive diagnosis was provided by combining clinical characteristics, and endoscopic and histopathologic features, after excluding other causes of gastrointestinal polyposis. The patient responds to corticosteroids, proton pump inhibitors, and nutritional support right after treatment. After 1 year of treatment, his symptoms ameliorated completely although colon polyps insignificantly reduced. Conclusion: Gastroenterologists should always be aware of patients with CCS with the following symptoms: gastrointestinal hamartomatous polyps, diarrhoea, and the dermatologic triad of alopecia, hyperpigmentation, and onychodystrophy.

A retrospective study of endogenous endophthalmitis-related pyogenic liver abscess: An increasing complication in North Vietnam.

Introduction: Endogenous endophthalmitis-related Klebsiella pyogenic liver abscess is a rare complication of metastatic infection. In most cases, visual acuity results are often impaired, even blind, and even with aggressive treatment with topical antibiotics, the final results are unsatisfactory. The objective of this study is to retrospectively based on medical records to describe clinical features, risk factors, and visual outcomes of patients with endogenous endophthalmitis-related pyogenic liver abscesses. Methods: We reported a case series of 12 endogenous endophthalmitis-related pyogenic liver abscess patients from March 2021 to 2023. All cases of endogenous endophthalmitis were diagnosed at admission or during the hospital stay. Results: From the medical records of 588 pyogenic liver abscess patients, we found 12 cases of endogenous endophthalmitis with 2.0%. The result showed a mean age of 61.5 ± 12.0 (41-78), diabetes mellitus (7 of 12), right lobe (7 of 12), single abscess (9 of 12), and the mean largest abscess diameter of 5.8 ± 1.7 cm (3.3-9). All patients had ocular symptoms such as eye pain (9 of 12), pus discharge (3 of 12), hypopyon (1 of 12), swollen eyelids (2 of 12), and corneal edema (2 of 12), pyogenic liver abscess before endogenous endophthalmitis (10 of 12), the median interval between endogenous endophthalmitis and pyogenic liver abscess 6.1 ± 1.9 days, ocular symptoms before diagnosis endogenous endophthalmitis 4.4 ± 2.3 days. All affected eyes were injected intravitreously with ceftazidime, amikacin, and vancomycin. Two patients underwent evisceration. Conclusions: Endogenous endophthalmitis has permanent morbidity, reducing visual acuity, poor quality of life, and lacks the warning signs, so it is essential for early detection of symptoms and referral to ophthalmologists.

Clinical, Laboratory and Bacterial Profile of Spontaneous Bacterial Peritonitis in Vietnamese Patients with Liver Cirrhosis.

Aim: To determine several clinical and laboratory features as well as the bacterial profile of spontaneous bacterial peritonitis (SBP) in 58 Vietnamese patients admitted to a single center due to liver cirrhosis. Methods: We retrospectively analyzed bacteriological, clinical and laboratory characteristics of patients with SBP admitted to the Gastroenterology and Hepatology Center from July 2019 to July 2020. Results: Out of a total 58 SBP patients, 41 (70.9%) had culture-negative neutrocytic ascites. The majority of patients experienced abdominal pain (93,1%) and large ascites (65,5%). Gram-negative bacteria formed the main pathogens (14/17). Escherichia coli (9/17) was the predominant cause followed by Burkholderia cepacia (2/17). Antibiotic sensitivity rate of E. coli for third generation cephalosporin was low but high for aminoglycoside and carbapenem antibiotics. The resistance of E. coli was significant against fluoroquinolones (100%). All 3 cases of gram-positive bacteria were sensitive to vancomycin. Conclusion: Our study reported the bacteriological and clinical characteristics of patients with SBP and compared these findings between two groups: positive ascitic fluid culture and negative fluid culture. Ascitic fluid culture can guide for the right antibiotic choice since resistance to commonly prescribed antibiotics is common in SBP patients.

A Prospective Pooled Analysis of Meat Mutagens and Colorectal Adenoma and Cancer in the US and EPIC Studies: Findings with an Emphasis on Improving Exposure Measurements.

BACKGROUND: In animal studies, heterocyclic amines (HCAs) are recognized as having strong carcinogenicity, therefore we have hypothesized that HCAs might be associated with the risk of colorectal adenoma (CRA) and cancer (CRC). METHODS: We used the Keywords of "Heterocyclic amines and colorectal cancer" to search, there were showing published articles (n=200). After reviews of titles, abstracts, and full articles, seven prospective cohort studies were included in the pooled analysis. Exposures to HCAs 2-amino-3,8-dimethylimidazo(4,5-j)quinoxaline (MeIQx), 2-amino-1-methyl-6-phenylimidazo(4,5-b)pyridine (PhIP), 2-amino-3,4,8-trimethylimidazo(4,5-f)quinoxaline (DiMeIQx), meat-derived mutagenicity (MDM), and the risk of CRA and CRC were examined. The estimated HCA intake as ng/day and ng/1,000 kcal/day by participants and by studies were examined. The ln(HR) and se(ln(HR)) were estimated from the multivariable-adjusted HR, 95%CI derived from seven published prospective studies in the US and EPIC. The random pooled multivariable-adjusted HR, 95%CI was analyzed using ln(HR) and se(ln(HR)) by STATA-10. RESULTS: For CRC and HCA intake, the null association was observed for MDM, the random pooled multivariable-adjusted HR, (95%CI): 1.11, (1.00, 1.23); for PhIP: 1.00, (0.91, 1.09); and for DiMeIQx: 1.03, (0.87, 1.22). A significant positive association was seen for MeIQx, the random pooled multivariable-adjusted HR, (95%CI):1.12, (1.03, 1.22). For CRA and HCA intake, the null association was observed for MDM, randomly pooled multivariable-adjusted HR, (95%CI): 1.15, (0.99, 1.34), and for DiMeIQx: 1.09, (0.97, 1.23). A significant positive association was seen for PhIP, the random pooled multivariable-adjusted HR, (95%CI): 1.19, (1.02, 1.39), and for MeIQx: 1.17, (1.01, 1.35). The major instances of HCAs were contributed by chicken (54%-74%) for PhIP and by red meat (83%-92%) for MeIQx. However, the estimated PhIP intake (ng/1,000 kcal/day) was remarkably different between studies. CONCLUSIONS: We observed a positive association between exposures to MeIQx and the risk of both CRC and CRA which supports the hypothesis of the role of HCAs in developing CRA and CRC. Improving the quality of the estimated HCA intake would be highly concerned for further investigation.

Vietnam Association of Gastroenterology (VNAGE) consensus on the management of Helicobacter pylori infection.

Helicobacter pylori (H. pylori) infection is prevalent and has a rapidly increasing antibiotic resistance rate in Vietnam. Reinfection is quite common, and gastric carcinoma remains one of the most common malignancies, which is not uncommon to develop after successful eradication. The purpose of this consensus is to provide updated recommendations on the management of H. pylori infection in the country. The consensus panel consisted of 32 experts from 14 major universities and institutions in Vietnam who were invited to review the evidence and develop the statements using the Delphi method. The process followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The consensus level was defined as ≥80% for agreement on the proposed statements. Due to the limited availability of high-quality local evidence, this consensus was also based on high-quality evidence from international studies, especially those conducted in other populations in the Asia-Pacific region. The panel finally reached a consensus on 27 statements after two voting rounds, which consisted of four sections (1) indications for testing and selection of diagnostic tests (2), treatment regimens, (3) post-treatment confirmation of H. pylori status, and (4) reinfection prevention methods and follow-up after eradication. Important issues that require further evidence include studies on third-line regimens, strategies to prevent H. pylori reinfection, and post-eradication follow-up for precancerous gastric lesions. We hope this consensus will help guide the current clinical practice in Vietnam and promote multicenter studies in the country and international collaborations.

Brunner's gland hyperplasia associated with lipomatous pseudohypertrophy of the pancreas presenting with gastrointestinal bleeding: A case report.

BACKGROUND: Brunner's gland hyperplasia (BGH) is a rare benign lesion of the duodenum. Lipomatous pseudohypertrophy (LiPH) of the pancreas is an extremely rare disease. Because each condition is rare, the probability of purely coincidental coexistence of both conditions is extremely low. CASE SUMMARY: We report a 26-year-old man presenting to our hospital with symptoms of recurrent upper gastrointestinal bleeding. Upper gastrointestinal endoscopy showed a huge pedunculated polypoid lesion in the duodenum with bleeding at the base of the lesion. Histopathological examination of the duodenal biopsy specimens showed BGH. Besides, abdominal computed tomography and magnetic resonance imaging revealed marked fat replacement over the entire pancreas, confirmed by histopathological evaluation on percutaneous pancreatic biopsies. Based on the radiological and histological findings, LiPH of the pancreas and BGH were diagnosed. The patient refused any surgical intervention. Therefore, he was managed with supportive treatment. The patient's symptoms improved and there was no further bleeding. CONCLUSION: This is the first well-documented case showing the coexistence of LiPH of the pancreas and BGH.