Endoscopic resection of inflammatory gastric fibroid polyp: A case report

Introduction An inflammatory fibroid polyp is a rare condition with frequent localization in the antrum of the stomach. Because of the localization in the bottom parts of the mucosa and submucosa, a histological diagnosis is difficult to establish at endoscopic biopsies. So, a correct diagnosis is histologically possible after surgical excision which is a common manner of treatment. Many authors have shown that endoscopic removal of an inflammatory fibroid polyp is possible. Case outline We are presenting a case of complete endoscopic resection of an inflammatory fibroid polyp of the stomach antrum in a 72-year-old patient. He complained of nausea, vomiting and loss of appetite. The polyp endoscopically looked like flat elevation with central umbilication, 16 mm in diameter and it was localized praepylorically. Pathohistologically, areas of severe epithelial dysplasia were verified at endoscopic biopsies which suggested early gastric cancer. Helicobacter pylori (H. pylori) infection was verified histologically and with rapid urease test. The patient was treated with triple eradication H. pylori therapy. Two months after the therapy, we decided to perform endoscopic resection of the polyp. We applied a suction technique of mucosal resection by which the polyp was completely resected. After complete endoscopic removal, the final diagnosis of an inflammatory fibroid polyp localised in the submucosa and mucosa of the antrum of the stomach was histologically made. On follow-ups, after 3, 6 and 12 months, there were no endoscopic and histological signs of either inflammatory fibroid polyp relapse, or recurrence of H. pylori infection. The patient had no dyspeptic symptoms. Conclusion We recommend an endoscopic method of resection as a therapy of choice for an inflammatory fibroid polyp of the stomach

Prediction of acute pancreatitis severity via the combined analysis of inflammatory biomarkers and coagulation parameters

Introduction. Timely assessment of severity of acute pancreatitis is needed to avoid severe systemic complications by making optimal therapeutic approach and correct prognosis of the disease. The aim of the study was to establish the role of several inflammatory biomarkers and coagulation parameters in prediction of AP severity, and also to propose a mathematical formula which allows their combined use for the same purpose. Material and Methods. The prospective study included 70 patients with AP. The patients were divided into groups: mild (group I), moderate (group II) and severe AP (group III). All patients were further classified into two groups: group A (mild AP) and group B (moderate and severe AP). Biochemical markers, inflammatory biomarkers and coagulation factors were tested in all patients. Results. Based on the results of Mann-Whitney,s test, it can be concluded that groups A and B are significant different from each other for CRP (p<0.05). Using the Wald’s stepwise forward method, a prediction model with CRP, PCT, D-dimer1, D-dimer3, fibrinogen1 and fibrinogen3 parameters as predictors of the severity of AP was obtained. The percentage of successful prediction of moderate or severe AP based on this model was 76.9%. The use of ROC analysis with the introduced linear combination from the logistic regression yielded equally good or even better results in the assessment of the severity of AP with the combined use of analyzed parameters. Conclusion. The combined analyses of biohumoral markers and coagulation parameters presented in the form a mathematical formula enabled a more accurate, rapid, rational and clinically available prediction of the severity of AP