Intestinal Research

Original Article

Infection

Comparative outcomes of acute colonic diverticulitis in immunocompromised versus immunocompetent patients: a systematic review and meta-analysis: Jae Gon Lee, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Shin Hee Lee, Myung-Won You, Seong-Eun Kim; Intest Res 2023;21(4):481-492. Published online May 31, 2023; DOI: https://doi.org/10.5217/ir.2023.00005

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Background/Aims
Immunocompromised patients with acute colonic diverticulitis are at high risk for complications and failure of non-surgical treatment. However, evidence on the comparative outcomes of immunocompromised and immunocompetent patients with diverticulitis is lacking. This systematic review and meta-analysis investigated the outcomes of medical treatment in immunocompromised and immunocompetent patients with diverticulitis.
Methods
A comprehensive literature search was conducted in PubMed, Embase, and the Cochrane Library. Studies comparing the clinical outcomes of immunocompromised and immunocompetent patients with diverticulitis were included.
Results
A total of 10 studies with 1,946,461 subjects were included in the quantitative synthesis. The risk of emergency surgery and postoperative mortality after emergency surgery was significantly higher in immunocompromised patients than in immunocompetent patients with diverticulitis (risk ratio [RR], 1.76; 95% confidence interval [CI], 1.31–2.38 and RR, 3.05; 95% CI, 1.70–5.45, respectively). Overall risk of complications associated with diverticulitis was non-significantly higher in immunocompromised than in immunocompetent patients (RR, 1.24; 95% CI, 0.95–1.63). Overall mortality irrespective of surgery was significantly higher in immunocompromised than in immunocompetent patients with diverticulitis (RR, 3.65; 95% CI, 1.73–7.69). By contrast, postoperative mortality after elective surgery was not significantly different between immunocompromised and immunocompetent patients with diverticulitis. In subgroup analysis, the risk of emergency surgery and recurrence was significantly higher in immunocompromised patients with complicated diverticulitis, whereas no significant difference was shown in mild disease.
Conclusions
Immunocompromised patients with diverticulitis should be given the best medical treatment with multidisciplinary approach because they had increased risks of surgery, postoperative morbidity, and mortality than immunocompetent patients.

Citations

Citations to this article as recorded by

Comparison of Outcomes Following Surgery for Diverticulitis Among Immunocompetent and Immunosuppressed Patients
Usama Waqar, Christina Gozza, Courtney L. Devin, Terrah J. Paul Olson, Seth A. Rosen
The American Surgeon™.2025;[Epub] CrossRef
Does type II diabetes mellitus increase the morbidity of patients with diverticulitis?
Marei H. Alshandeer, Walid M. Abd El Maksoud, Khaled S. Abbas, Fahad S. Al Amri, Maha A. Alghamdi, Hassan A. Alzahrani, Abdullah Dalboh, Mohammed A. Bawahab, Aisha J. Asiri, Yahia Assiri
Medicine.2024; 103(46): e40567. CrossRef
Not all acute colonic diverticulitis follows the same course: a potential risk for immunocompromised individuals
Yehyun Park
Intestinal Research.2023; 21(4): 415. CrossRef

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Statement

Endoscopy

Use of device-assisted enteroscopy in small bowel disease: an expert consensus statement by the Korean Association for the Study of Intestinal Diseases: Han Hee Lee, Jin Su Kim, Hyeon Jeong Goong, Shin Hee Lee, Eun Hye Oh, Jihye Park, Min Cheol Kim, Kwangwoo Nam, Young Joo Yang, Tae Jun Kim, Seung-Joo Nam, Hee Seok Moon, Jae Hyun Kim, Duk Hwan Kim, Seong-Eun Kim, Seong Ran Jeon, Seung-Jae Myung, The Small Intestine Research Group of the Korean Association for the Study of Intestinal Diseases (KASID); Intest Res 2023;21(1):3-19. Published online January 31, 2023; DOI: https://doi.org/10.5217/ir.2022.00108

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The introduction of device-assisted enteroscopy (DAE) in the beginning of 21st century has revolutionized the diagnosis and treatment of diseases of the small intestine. In contrast to capsule endoscopy, the other main diagnostic modality of the small bowel diseases, DAE has the unique advantages of observing the region of interest in detail and enabling tissue acquisition and therapeutic intervention. As DAE becomes an essential procedure in daily clinical practice, there is an increasing need for correct guidelines on when and how to perform it and what technical factors should be considered. In response to these needs, the Korean Association for the Study of Intestinal Diseases developed an expert consensus statement on the performance of DAE by reviewing the current evidence. This expert consensus statement particularly focuses on the indications, choice of insertion route, therapeutic intervention, complications, and relevant technical points.

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Jihye Park, Jin Su Kim, Joo Hye Song, Kwangwoo Nam, Seong-Eun Kim, Eui Sun Jeong, Jae Hyun Kim, Seong Ran Jeon
Gut and Liver.2024; 18(4): 686. CrossRef

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Letters to the Editor

IBD

Update on SARS-CoV-2 vaccination of patients with inflammatory bowel disease: what clinicians need to know: Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Seung-Jae Myung, Clinical Practice Guideline Committee of the Korean Association for the Study of Intestinal Diseases; Intest Res 2022;20(3):386-388. Published online March 11, 2022; DOI: https://doi.org/10.5217/ir.2020.00172

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Statements

IBD

Korean Association for the Study of Intestinal Diseases guidance for clinical practice of adult inflammatory bowel disease during the coronavirus disease 2019 pandemic: expert consensus statements: Yong Eun Park, Yoo Jin Lee, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seong-Eun Kim, Seung-Jae Myung; Intest Res 2022;20(4):431-444. Published online January 5, 2022; DOI: https://doi.org/10.5217/ir.2021.00111

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Many unexpected problems have resulted from the unprecedented coronavirus disease 2019 (COVID-19) pandemic. The optimal management of patients with inflammatory bowel disease (IBD) during the COVID-19 pandemic has also been a challenge. Therefore, the Korean Association for the Study of Intestinal Diseases (KASID) developed a consensus statement of experts regarding the management of IBD during the COVID-19 pandemic. This consensus statement made recommendations regarding the risk and treatment of COVID-19 in IBD patients. This statement emphasizes that IBD is not a risk factor for COVID-19, and care should be taken not to exacerbate IBD in patients in remission state by maintaining their medications, except for corticosteroids.

Citations

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Mobile monitoring system detects the disease activity pattern and shows the association with clinical outcomes in patients with newly diagnosed Crohn’s disease
Yoo Jin Lee, Sang Gyu Kwak, Eun Soo Kim, Sung Kook Kim, Hyun Seok Lee, Yun Jin Chung, Byung Ik Jang, Kyeong Ok Kim, Jeongseok Kim, Hyeong Ho Jo, Eun Young Kim
Scientific Reports.2024;[Epub] CrossRef
Update on SARS-CoV-2 vaccination of patients with inflammatory bowel disease: what clinicians need to know
Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Seung-Jae Myung
Intestinal Research.2022; 20(3): 386. CrossRef

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IBD

SARS-CoV-2 vaccination for adult patients with inflammatory bowel disease: expert consensus statement by KASID: Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seung-Jae Myung, The Clinical Practice Guideline Committee of the Korean Association for the Study of the Intestinal Diseases (KASID); Intest Res 2022;20(2):171-183. Published online January 5, 2022; DOI: https://doi.org/10.5217/ir.2021.00098

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Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, is threatening global health worldwide with unprecedented contagiousness and severity. The best strategy to overcome COVID-19 is a vaccine. Various vaccines are currently being developed, and mass vaccination is in progress. Despite the very encouraging clinical trial results of these vaccines, there is insufficient information on the safety and efficacy of vaccines for inflammatory bowel disease (IBD) patients facing various issues. After reviewing current evidence and international guidelines, the Korean Association for the Study of Intestinal Diseases developed an expert consensus statement on COVID-19 vaccination issues for Korean IBD patients. This expert consensus statement emphasizes that severe acute respiratory syndrome coronavirus 2 vaccination be strongly recommended for IBD patients, and it is safe for IBD patients receiving immunomodulatory therapy.

Citations

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Intestinal Research.2024; 22(3): 336. CrossRef
Vaccination in patients with inflammatory bowel disease–Asian perspectives: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting
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Yoo Jin Lee, Eun Soo Kim
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Focused Review

Colorectal neoplasia

Nutritional issues in patients with cancer: Duk Hwan Kim; Intest Res 2019;17(4):455-462. Published online October 14, 2019; DOI: https://doi.org/10.5217/ir.2019.00076

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Cancer is a catabolic inflammatory disease that causes patients to often experience weight loss, or even cachexia in severe cases. Undernourishment in patients with cancer impairs the quality of life and therapeutic response, further leading to poor prognosis. Active and frequent nutritional screening and assessment using valid tools are important for fast and appropriate nutritional intervention. Additionally, a suitable individualized nutritional intervention strategy should be established based on the nutritional assessment result. In general, nutritional intervention begins with nutritional counseling of patients diagnosed with cancer, and a well-planned nutritional counseling improves the treatment adherence and nutritional status. When planning nutritional supplementation for cancer patients, specific nutrients, including amino acids and fatty acids, should be considered. However, there has been no consistent result showing that any particular nutrient significantly improves the prognosis of cancer patients. Hence, continuous attention from clinical physicians is needed to plan nutritional improvement in patients with cancer.

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Images of the Issue

A massive bleeding from a duodenal mass: what treatment option should be chosen?: Duk Hwan Kim; Intest Res 2017;15(4):548-549. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.548

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Case Report

A Case of Ileal Mucormycosis in a Patient with Gastrointestinal Behcet's Disease: Song Yi Han, Duk Hwan Kim, Jae Jun Park, Chang Mo Moon, Eun Soo Kim, Jae Hee Cheon, Tae Il Kim, Seung Hyuk Baik, Hogeun Kim, Won Ho Kim; Intest Res 2008;6(2):140-144. Published online December 30, 2008

Abstract PDF: Zygomycosis (mucormycosis) is a rare fungal infectious disease, usually found in association with an immunocompromised state. Gastrointestinal mucormycosis is extremely rare and fatal, thus it is important to detect and manage this disease at an early stage in an effort to improve survival. To date, no cases of mucormycosis superimposed on gastrointestinal Behcet's disease have been reported. Herein we report a case in which gastrointestinal mucormycosis occurred in a 17-year-old-female with Behcet's disease. The patient recovered from her disease after undergoing an ileocecectomy. (Intest Res 2008;6:140-144)

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