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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_2948_Библиотеки_им_академика_М_И_Перельмана
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418
PRES (posterior reversible encephalopathy syndrome), which is occasionally a side
effect of tacrolimus. But in many cases, the mental changes are unrelated and self-
limited and not a reason to give up on tacrolimus.
I think that having patients on tacrolimus instead of cyclosporine is important,
whenever possible. Some patients are on mTOR inhibitors, which are not as strong
immune suppressing drugs. If a patient is on an mTOR inhibitor alone, like siroli-
mus or everolimus, they are far more likely to have rejection than a patient who is
on an mTOR inhibitor, along with a calcineurin inhibitor. While it’s pretty unusual
to be on monotherapy with an mTOR inhibitor, I do see it from time to time. Those
are some of the drug choices that are occasionally problematic.
V. L o y
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419© The Editor(s) (if applicable) and The Author(s), under exclusive license to
Springer Nature Switzerland AG 2023
W. H. Sobin et al. (eds.), Managing Complex Cases in Gastroenterology,
https://doi.org/10.1007/978-3-031-48949-5
A
Abdominal aortic aneurysm (AAA), 96
Ablation, 50
Abnormal liver enzymes, 281
Achalasia
absent contractility, 19
diagnosis of, 21
EGJOO, 23
GERD, 18
manometry, 21
pharmacologic therapy, 20
pseudoachalasia, 23
timed barium esophagram, 19
TTS dilation, 22
Acute bowel ischemia, 92
Acute diarrhea, 74–75
Acute liver failure, 396
necrosis, 403, 404
patient history, 403
steroids, 404
Acute mesenteric insufciency (AMI), 101
Acute severe ulcerative colitis (ASUC), 202,
205, 206
Adalimumab, 187
AFP, 342, 355
Alcoholic cirrhosis, 333, 334
Alcoholic hepatitis, 323, 324
Alcoholic liver disease, 319–321
Alcohol induced liver disease, 282
Alcohol relapse, 343
Alkaline phosphatase, 404
ALP, 376
Alpha-1-antitrypsin deciency, 282, 295,
299, 331
AMA, 366
American Association for the Study of Liver
Diseases (AASLD), 342
American Society of Colon and Rectal
Surgeons (ASCRS), 131
Anal incontinence, 122
Anecdotal evidence, 112
Anorectal manometry, 74
Antibiotics, 129
Anticoagulation, 347–349
Anti-TNFs, 212
Arthralgias, 366
Ascites, 331, 332
alcoholic cirrhosis, 341
alcohol relapse, 343
complications, 345, 346
hepatoma, 342
PEth levels, 341, 342
surveillance, 342
without obvious
cirrhosis, 329, 330
Autoimmune hepatitis (AIH)
azathioprine, 380
burned out, 373, 374
and cirrhosis, 369
diagnosis, 379
liver biopsy, 371, 373
mycophenolate, 372
patient history, 369, 371
pregnancy, 373
side effect, 372, 373
steroids, 380
treatment, 369
UDCA, 379
Index
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420
Autoimmune metaplastic atrophic
gastritis (AMAG)
diagnosis, 65
evaluation, 65
gastric cancer, 66
Azathioprine, 187, 369, 372, 373, 380
B
Baclofen, 343
Balloon ablation, 51
Balloon occluded retrograde transvenous
obliteration (BRTO), 338, 339
Barrett’s esophagus (BE)., 51
Behavioral precautions, 126
Biofeedback therapy, 124
Bloating, 253
baseline hydrogen, 276
brain fog, 273
constipation, 273
delayed small bowel motility, 275
diabetes, 275
distension
FODMAP, 271, 272
Linzess, 272
viscerosomatic reex, 271
metamucil, 274
rifaximin, 276
SNRIs, 272
visceral hypersensitivity, 274, 275
Blood pressure, 11
Bone disease, 367
Boston Scientic and STERIS, 111
Budd-Chiari syndrome, 330, 351, 352
Budesonide, 372
C
Calcineurin inhibitors (CNI), 373, 416, 418
Cannabinoid hyperemesis syndrome
(CHS), 269
CAPOX, 152
Cardiac cirrhosis, 330
C-arm, 340
Cecal polyps, 116
Celiac disease, 299
Ceruloplasmin, 291–293
Checkpoint inhibitors, 157
Cholangiocarcinoma, 376, 377
Cholangitis lenta, 302
Cholestyramine, 361
Chromoendoscopy, 200
Chronic abdominal pain, 87
Chronic mesenteric ischemia, 104
Chronic pancreatitis
asymptomatic, 149
differential diagnosis, 148
medications, 149
pain, 146
secretin-stimulated MRI, 146
weight loss, 147
Cirrhosis, 281, 329–331, 353, 369
CMV, 416
Cold EMR, 112
Cold snare polypectomy, 109, 110, 115
Colestipol, 361
Colon cancer, 88
Colon ischemia (CI), 105
Colonoscopy, 197
Colon purge, 126
Computed tomography (CT) interpretation, 58
Constipation/irritable bowel syndrome-
constipation predominant (IBS-C),
73–74, 123
chloride channel receptor, 262
colonoscopy, 261
ber, 261, 262
guanylate cyclase receptor, 262
laxatives, 264
linaclotide, 262
Miralax, 262
misoprostol, 263
outlet dysfunction, 264
prucalopride, 262
rectal disimpaction, 263
Sitzmarks study, 265
strategies, 265
Corkscrew esophagus, 30
Crohn's disease, 183, 236
bloating, 239, 240
budesonide, 184
cholestyramine, 219, 220
immunomodulator, 186
iniximab, 223, 224
medical option, 185
patency capsule, 183
perianal stulae, 186
smoking patients, 184
vedolizumab levels, 185
Cyclosporine, 373, 417
CYP2C19 polymorphism, 34
D
Diarrhea, 241, 242
Direct intrahepatic portosystemic shunt
(DIPS), 339
Direct oral anticoagulants (DOAC), 348, 349
Index
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421
Disorder of gut-brain interaction (DGBI), 90
Distal cholangiocarcinomas, 377
Diuretic dose, 345, 346
Diverticulitis, 78–79, 130
Dupilumab, 11
Dyslipidemia, 366
Dysphagia, 12
Dysplasia, 200
Dyssynergic defecation, 126
E
EASL, 383
Elective surgery, 131
Endometriosis, 92
Endoscopic eradication therapy (EET), 48
Endoscopic mucosal resection
(EMR), 5, 113
Endoscopic retrograde
cholangiopancreatography
(ERCP), 92, 376
Endoscopy
pH testing, 32
PPIs, 32
Entecavir, 388, 392
Eosinophilic esophagitis (EOE), 7, 8
Esophageal manometry, 43
Esophageal varices, 283, 335–338
Ethanolamine oleate (EO), 338
Ethanol glucuronide (EtG), 342
Extraintestinal manifestations (EIMs), 212
Extramural lesions, 69
F
Fatigue, 360
FD-epigastric pain syndrome (EPS), 253
Fecal incontinence, 78
Fermentable oligosaccharides, disaccharides,
monosaccharides and polyols
(FODMAP), 271, 272
FibroScan®, 327, 388, 402
Fibrostenotic disease, 12
Flexible sigmoidoscopy, 208
Fluticasone, 10
FOLFOX, 152
Fomepizole, 406
Functional diarrhea, 219, 220
Functional dyspepsia (FD), 91, 253
abdominal burning pain, 269
buspirone, 268
cannabinoids, 269
delayed gastric emptying, 268
diagnosis, 268
mirtazapine, 268, 269
Functional dyspepsia-epigastric pain
syndrome type, 269
Functional heartburn, 36
G
Gallbladder, 89, 376
Gastric adenocarcinoma, 66
Gastric carcinoids, 70
Gastric mapping, 67
Gastric perforations, 63
Gastric varices, 337
banding, 339
bleeding diathesis, 340
BRTO, 338
esophageal varices, 337
management, 337, 338
patient history, 337
TIPS, 339
Gastroenterologists, 116
Gastroesophageal reux disease (GERD),
3, 31, 41
Gastrointestinal (GI), 6
adenocarcinoma, 156
autoimmune hepatitis, 176–177
checkpoint inhibitor, 154
chronic constipation, 171–172
EGFR inhibitors, 153
eosinophilic esophagitis (EOE), 167
5FU and leucovorin, 152
gastroenterologists, 177
genetic testing, 157
Helicobacter pylori, 168–171
hepatitis B, 174
hepatitis C, 173–174
inammatory bowel
disease, 175–176
KRAS mutations, 153
leucovorin, 153
metastatic disease, 154
pancreatic insufciency, 174–175
PARP inhibitors, 158
systemic chemotherapy, 155
tyrosine kinase inhibitor therapy, 155
Gastroparesis, 76–77
GERD Consensus Conference, 42
GERD-related stricture, 13
Gilbert’s, 297, 298
G-J tube, 57
Golytely, 125
GOV-1 varices, 339
G tube dysfunction, 54
Gut-brain interaction, 253
Index
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422
H
Hashimoto’s disease, 371
Heartburn, 37
Hematemesis, 337
Hemochromatosis, 289, 290, 331
Hepatic encephalopathy, 346, 395
Hepatic steatosis, 303–305, 325
Hepatitis A virus (HAV), 367
Hepatitis B envelope antigen positive
(HBeAg), 381, 385, 386
Hepatitis B surface antibody (HBsAb), 397
Hepatitis B vaccine (HBV), 284
acute exacerbation, 395, 396
follow-up, 397
immune-active chronic HBV
HBeAg, 385–388
long-term treatment, 388
patient history, 385
TDF, 387, 388
immune-tolerant chronic HBV
anti-viral therapy, 382
chronic hepatitis B, 383
issues, 382, 383
liver biopsy, 382
patient history, 381
phase of, 381
rituximab, 397–399
treatment, 391, 392
Hepatitis B virus (HBV), 367
Hepatitis C, 281
Hepatitis C vaccine (HCV)
brosis, 402
impression, 401, 402
patient history, 401
Hepatocellular carcinoma (HCC), 283, 353,
355, 357, 367, 382
Hepatoma, 342
Hepatosplenic T cell lymphoma (HSTCL),
225, 226
High-density lipoproteins (HDL), 366
High-grade dysplasia (HGD), 48
Holistic management, 363
Hyperbilirubinemia, 282, 301, 302
Hyperlipidemia, 366
I
IgG4, 376
Ileal ulcer
budesonide, 236
calprotectin, 235
Immunosuppression, 237, 238, 416
Ineffective motility (IEM), 44
Inammatory bowel disease (IBD), 181, 376
adalimumab, 245, 246
anti-TNF, 246, 247
azathioprine, 246, 247
iniximab, 245–247
ozanimod, risankizumab and upadacitinib,
247, 248
recurrence rate, 245, 246
self-injection, 231, 232
tacrolimus, 232
vedolizumab, 248
Infusion, 221
Interferon, 396
Intestinal ischemia, 347
Intrahepatic cholangiocarcinoma, 377
Iron overload, 290
Irritable-bowel syndrome-diarrhea
predominant (IBS-D)
abdominal cramps
dicyclomine, 258
eluxadoline, 258, 259
lidocaine, 258
quetiapine, 259
SNRI, 259
alosetron, 257
celiac serology, 255, 256
colonoscopy, 255
depression, 256, 257
dicyclomine, 256
eluxadoline, 256
IBgard, 256
tricyclics, 257
J
JAK inhibitors, 210
JAMA surgery, 131
Jaundice, 370
L
Lamivudine, 396
Levothyroxine, 371
Lift polyps, 114
LINX anti-reux system, 43
Liposoluble vitamin deciencies, 367
Liver biopsy, 365, 366, 371
Liver disease, 284, 319–321, 327
Liver enzyme abnormality, 299, 300
drug-induced liver injury, 286
FibroScan
®
, 286
history, 285
intravenous drugs, 286
Index
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423
liver biopsy, 287
paroxysmal nocturnal dyspnea, 285
physical exam, 285
thyroid disease, 286
Liver transplantation, 284
candidates for, 407–409
complications, 415–418
frustrations, 411–413
Locoregional therapies, 356
Low-density lipoproteins (LDL), 366
Low SAAG ascites, 333, 334
M
Magnetic resonance cholangiopancreatography
(MRCP), 92, 376
Mayo protocol, 377
Median arcuate ligament syndrome
(MALS), 89, 107
Medically refractory reux, 45
Medical regimens, 38
6-Mercaptopurine (6-MP), 372
Mesenteric vein thrombosis (MVT), 103
Metabolic associated steatohepatitis
(MetASH), 365
Metabolic dysfunction associated steatotic
liver disease (MASLD), 303–305
active research and clinical trials, 313
AST and ALT, 310
bariatric surgery, 315, 316
FibroScan®, 310, 311
GLP-1 agonist, 316
histological parameters, 311, 312
inammatory process, 313
liver biopsy, 311
liver transplantation, 316
management, 317
pioglitazone, 316
stage 3 brosis, 314, 315
steatohepatitis, 313
steatosis, 312
vitamin E, 312, 314, 316
weight loss and abstention, 309, 310
Microscopic colitis (MC)
budesonide, 243, 244
vedolizumab, 244
Minnesota tube, 340
Model for end-stage liver disease (MELD)
score, 346
Mononuclear cells, 332
Motility disorders
Botox injections, 27
chest pain and dysphagia, 25
classic type 1 achalasia, 29
dysphagia, 27
esophageal motility disorder, 28
Jackhammer esophagus, 26
nutcracker, 26
pan-pressurization, 29
sedation, 26
Myalgias, 366
Mycophenolate, 416
Mycophenolate mofetil (MMF), 372, 373
Mycophenolic acid (MPA), 372
Myocardial infarction
ASCA/ANCA diagnosis, 193
c diff NAAT, 195
Crohn's disease, 194
JAK-inhibitors, 195
ustekinumab, 194
N
Narcotic pain medications, 91
Necrosis, 403, 404
Neuroendocrine tumors, 70
Non-alcoholic fatty liver disease (NAFLD),
303, 305, 357
biomarkers, 304
FibroScan®, 304, 305
liver biopsy, 305
MASLD, 304, 305
NASH, 304
overview, 303
treatment, 307, 308
Non-alcoholic steatohepatitis
(NASH), 304
Non-dysplastic Barrett’s esophagus
(NDBE), 47
Nonocclusive mesenteric ischemia
(NOMI), 105
Non-steroidal anti-inammatory drugs
(NSAIDs), 133
O
Obeticholic acid (OCA), 362, 366
Omeprazole-bicarbonate, 34
Oral contraceptive pills (OCPs), 93
Oropharyngeal dysphagia, 15–16
P
Pancreatic cancer
checkpoint inhibitors, 158
gastroenterologist, 158
Index
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424
Pancreatic cysts
autoimmune pancreatitis, 143
genetic etiology, 142
IPMNs, 141
MRCP, 143
recurrent idiopathic pancreatitis, 142
serum CA 19-9, 140
Pantoprazole, 11
Paris classication, 117
Pedunculated polyp, 118–119
PEG, 4, 57
bumper, 61
DOACs/Plavix, 62
gastroenterologists, 53
gauze, 61
infections, 54
placement, 59
PEG-J tube, 63
Phosphatidylethanol (PEth), 341, 342
Photodynamic therapy, 50
Pneumocystis jirovecii, 237, 238
Polypectomy, 111–113
Portal hypertension, 370
Portal vein thrombosis (PVT), 283, 347, 351,
352, 355, 356
Post-cholecystectomy diarrhea, 75
Post-op dysphagia, 44
Post-polypectomy bleeding, 119–120
Postprandial distress syndrome (PDS), 253
PPI standpoint, 11
Prednisolone, 380
Prednisone, 94, 369, 380, 416
Pregnancy, 373
Primary biliary cholangitis (PBC)
AMA levels, 366
azathioprine, 380
colestipol, 361
diagnosis, 359, 360, 379
grade A cirrhosis, 362
hepatic decompensation, 363
lipid levels, 366
liver biopsy, 365, 366
liver enzymes, 363
obeticholic acid, 362
OCA, 366
patient history, 359, 365
pruritus, 361
steroids, 380
symptoms, 360, 361
treatment, 362
ursodeoxycholic acid, 360–362, 366,
367, 379
Primary sclerosing cholangitis (PSC)
cholangiocarcinoma, 377
diagnosis, 375
IgG4, 376
management, 376, 377
patient history, 375
surveillance, 376
UDCA, 376
Pyoderma gangrenosum (PG), 227
R
Rectal exam, 124
Rectal incontinence, 121
Reux hypersensitivity, 36
Refractory benign esophageal stricture
(RBES), 159–162
chemoradiation, 161
esophageal stents, 159–162
etiology, 159
extrinsic compression, 162
pancreatic cancer, 163–165
self-dilation, 160
self-expanding stent, 160
stent role, 161
Refractory GERD, 37–39
Resistant/refractory proctitis, 208
Rheumatoid arthritis (RA), 95
Rituximab, 397–399
S
Sacral nerve stimulation, 123
Segmental colitis associated with
diverticulosis (SCAD), 5, 134
Senna, 74
Serotonin and norepinephrine reuptake
inhibitor (SNRI), 259, 272
Serum albumin-ascites albumin gradient
(SAAG), 283, 329, 330
Sicca complex symptoms, 361
Sigmoid colectomy, 136
Sinusoidal obstruction syndrome (SOS), 330
Small bowel carcinoids, 71
Small bowel obstruction, 197
Small intestinal bacterial overgrowth (SIBO), 4
breath tests, 85
predispose, 82
Small nodule, 50
Steatohepatitic hepatocellular carcinoma, 357
Steroids, 369
Superior mesenteric vein (SMV), 347
Index
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425
T
Tacrolimus, 372, 373, 418
Tenofovir, 392
Terlipressin, 338
Thiopurine methyltransferase (TPMT), 372
Thrombocytopenia, 347
Thromboelastogram (TEG), 340
Thrombosis, 337
Total protein (TP), 329
Transferrin saturation (TS), 289
Transjugular intrahepatic portosystemic shunt
(TIPS), 339
Transoral incisionless fundoplication
(TIF), 4, 46
Trastuzumab, 156
Tuberculosis, 332
Tylenol overdose, 403, 405
U
Ulcerative colitis (UC), 335, 336, 351
colon stricture, 233, 234
immune modulators
azathioprine, 225, 226
methotrexate, 226
monotherapy, 225
iniximab, 221
JAK inhibitors, 201
mesalamine, 189, 215, 216
ozanimod, 190
pyoderma gangrenosum, 227
tofacitinib, 229
upadacitinib, 229
ustekinumab, 229, 230
vedolizumab, 215, 216
Upadacitinib, 203
Ursodeoxycholic acid (UDCA), 360–362, 366
PBC-AIH overlap syndrome, 379
in PSC, 376
Ustekinumab (UST), 190
V
Vascular disorders, 101, 103
Vedolizumab (VDZ), 190
Viokase (pancreatic enzyme), 56
W
Warfarin, 348
Wilson’s disease, 282, 291–293, 299
Wound care, 55
Index
https://t.me/medicina_free
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