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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
AbstractAbstract PDFSupplementary MaterialPubReaderePub
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
  • 4,083 View
  • 359 Download
  • 3 Web of Science
  • 3 Crossref
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IBD
Clinical outcomes and predictors of response for adalimumab in patients with moderately to severely active ulcerative colitis: a KASID prospective multicenter cohort study
Seung Yong Shin, Soo Jung Park, Young Kim, Jong Pil Im, Hyo Jong Kim, Kang-Moon Lee, Ji Won Kim, Sung-Ae Jung, Jun Lee, Sang-Bum Kang, Sung Jae Shin, Eun Sun Kim, You Sun Kim, Tae Oh Kim, Hyun-Soo Kim, Dong Il Park, Hyung Kil Kim, Eun Soo Kim, Young-Ho Kim, Do Hyun Kim, Dennis Teng, Jong-Hwa Kim, Wonyong Kim, Chang Hwan Choi, on behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases
Intest Res 2022;20(3):350-360.   Published online July 23, 2021
DOI: https://doi.org/10.5217/ir.2021.00049
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
This study assessed the efficacy and safety of adalimumab (ADA) and explored predictors of response in Korean patients with ulcerative colitis (UC).
Methods
A prospective, observational, multicenter study was conducted over 56 weeks in adult patients with moderately to severely active UC who received ADA. Clinical response, remission, and mucosal healing were assessed using the Mayo score.
Results
A total of 146 patients were enrolled from 17 academic hospitals. Clinical response rates were 52.1% and 37.7% and clinical remission rates were 24.0% and 22.0% at weeks 8 and 56, respectively. Mucosal healing rates were 39.0% and 30.1% at weeks 8 and 56, respectively. Prior use of anti-tumor necrosis factor-α (anti-TNF-α) did not affect clinical and endoscopic responses. The ADA drug level was significantly higher in patients with better outcomes at week 8 (P<0.05). In patients with lower endoscopic activity, higher body mass index, and higher serum albumin levels at baseline, the clinical response rate was higher at week 8. In patients with lower Mayo scores and C-reactive protein levels, clinical responses, and mucosal healing at week 8, the clinical response rate was higher at week 56. Serious adverse drug reactions were identified in 2.8% of patients.
Conclusions
ADA is effective and safe for induction and maintenance in Korean patients with UC, regardless of prior anti-TNF-α therapy. The ADA drug level is associated with the efficacy of induction therapy. Patients with better short-term outcomes were predictive of those with an improved long-term response.

Citations

Citations to this article as recorded by  
  • Prospective Observational Evaluation of the Time-Dependency of Adalimumab Immunogenicity and Drug Concentration in Ulcerative Colitis Patients: the POETIC II Study
    Sivan Harnik, Chaya M Abitbol, Ola Haj Natour, Miri Yavzori, Ella Fudim, Orit Picard, Timna Naftali, Efrat Broide, Ayal Hirsch, Limor Selinger, Eyal Shachar, Doron Yablecovitch, Ahmad Albshesh, Daniel Coscas, Uri Kopylov, Rami Eliakim, Shomron Ben-Horin,
    Journal of Crohn's and Colitis.2024; 18(3): 341.     CrossRef
  • Rapidly achieving clinical remission in ulcerative colitis indicates better endoscopic and histological outcomes
    Rirong Chen, Yizhe Tie, Yongle Huang, Xi Zhang, Zhirong Zeng, Minhu Chen, Li Li, Shenghong Zhang
    United European Gastroenterology Journal.2024; 12(4): 459.     CrossRef
  • Effectiveness of adalimumab in severe ulcerative colitis: A systematic review and a meta‐analysis
    Saleh Azadbakht, Masomeh Seighali, Salehe Azadbakht, Morteza Azadbakht
    Health Science Reports.2024;[Epub]     CrossRef
  • Dynamic changes in the gut microbiota composition during adalimumab therapy in patients with ulcerative colitis: implications for treatment response prediction and therapeutic targets
    Han Na Oh, Seung Yong Shin, Jong-Hwa Kim, Jihye Baek, Hyo Jong Kim, Kang-Moon Lee, Soo Jung Park, Seok-Young Kim, Hyung-Kyoon Choi, Wonyong Kim, Woo Jun Sul, Chang Hwan Choi
    Gut Pathogens.2024;[Epub]     CrossRef
  • Real-world effectiveness and safety of advanced therapies for the treatment of moderate-to-severe ulcerative colitis: Evidence from a systematic literature review
    Peter M. Irving, Peter Hur, Raju Gautam, Xiang Guo, Severine Vermeire
    Journal of Managed Care & Specialty Pharmacy.2024; 30(9): 1026.     CrossRef
  • Korean clinical practice guidelines on biologics and small molecules for moderate-to-severe ulcerative colitis
    Soo-Young Na, Chang Hwan Choi, Eun Mi Song, Ki Bae Bang, Sang Hyoung Park, Eun Soo Kim, Jae Jun Park, Bora Keum, Chang Kyun Lee, Bo-In Lee, Seung-Bum Ryoo, Seong-Joon Koh, Miyoung Choi, Joo Sung Kim
    Intestinal Research.2023; 21(1): 61.     CrossRef
  • Changes in fecal metabolic and lipidomic features by anti-TNF treatment and prediction of clinical remission in patients with ulcerative colitis
    Seok-Young Kim, Seung Yong Shin, Soo Jung Park, Jong Pil Im, Hyo Jong Kim, Kang-Moon Lee, Ji Won Kim, Sung-Ae Jung, Jun Lee, Sang-Bum Kang, Sung Jae Shin, Eun Sun Kim, You Sun Kim, Tae Oh Kim, Hyun-Soo Kim, Dong Il Park, Hyung Kil Kim, Eun Soo Kim, Young-
    Therapeutic Advances in Gastroenterology.2023;[Epub]     CrossRef
  • Reviewing not Homer’s Iliad, but “Kai Bao Ben Cao”: indigo dye—the past, present, and future
    Yusuke Yoshimatsu, Tomohisa Sujino, Takanori Kanai
    Intestinal Research.2023; 21(2): 174.     CrossRef
  • Precision medicine and drug optimization in adult inflammatory bowel disease patients
    Sophie Vieujean, Edouard Louis
    Therapeutic Advances in Gastroenterology.2023;[Epub]     CrossRef
  • Real-world effectiveness and safety of adalimumab in Korean patients with intestinal Behcet’s disease: a Korean Association for the Study of Intestinal Diseases (KASID) multicenter study
    Seung Bum Lee, Hee Seung Hong, Chang Kyun Lee, Bo-In Lee, Sol Kim, Seong-Joon Koh, Hosun Yu, Jung-Bin Park, Sung Wook Hwang, Byong Duk Ye, Suk-Kyun Yang, Sang Hyoung Park
    The Korean Journal of Internal Medicine.2023; 38(5): 661.     CrossRef
  • Advancements in the Management of Moderate-to-Severe Ulcerative Colitis: A Revised 2023 Korean Treatment Guidelines
    Soo-Young Na
    The Korean Journal of Medicine.2023; 98(5): 223.     CrossRef
  • Prediction of Clinical Remission with Adalimumab Therapy in Patients with Ulcerative Colitis by Fourier Transform–Infrared Spectroscopy Coupled with Machine Learning Algorithms
    Seok-Young Kim, Seung Yong Shin, Maham Saeed, Ji Eun Ryu, Jung-Seop Kim, Junyoung Ahn, Youngmi Jung, Jung Min Moon, Chang Hwan Choi, Hyung-Kyoon Choi
    Metabolites.2023; 14(1): 2.     CrossRef
  • Association of C-reactive Protein and Partial Mayo Score With Response to Tofacitinib Induction Therapy: Results From the Ulcerative Colitis Clinical Program
    Marla C Dubinsky, Fernando Magro, Flavio Steinwurz, David P Hudesman, Jami A Kinnucan, Ryan C Ungaro, Markus F Neurath, Nicole Kulisek, Jerome Paulissen, Chinyu Su, Dario Ponce de Leon, Miguel Regueiro
    Inflammatory Bowel Diseases.2022;[Epub]     CrossRef
  • Effectiveness and Safety of Golimumab in Patients with Ulcerative Colitis: A Multicenter, Prospective, Postmarketing Surveillance Study
    Jongwook Yu, Soo Jung Park, Hyung Wook Kim, Yun Jeong Lim, Jihye Park, Jae Myung Cha, Byong Duk Ye, Tae Oh Kim, Hyun-Soo Kim, Hyun Seok Lee, Su Young Jung, Youngdoe Kim, Chang Hwan Choi
    Gut and Liver.2022; 16(5): 764.     CrossRef
  • Pharmacogenetics-based personalized treatment in patients with inflammatory bowel disease: A review
    Ji Young Chang, Jae Hee Cheon
    Precision and Future Medicine.2021; 5(4): 151.     CrossRef
  • 8,850 View
  • 668 Download
  • 17 Web of Science
  • 15 Crossref
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Colorectal neoplasia
Clinical features and outcomes in spontaneous intramural small bowel hematoma: cohort study and literature review
Eun Ae Kang, Seung Jun Han, Jaeyoung Chun, Hyun Jung Lee, Hyunsoo Chung, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Hyun Chae Jung
Intest Res 2019;17(1):135-143.   Published online October 10, 2018
DOI: https://doi.org/10.5217/ir.2018.00085
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Spontaneous intramural small bowel hematoma (SISBH) is an extremely rare complication of anticoagulant or antiplatelet therapy. We assessed the clinical characteristics and outcomes of patients with SISBH according to the anatomical location of the hematoma.
Methods
From January 2003 to February 2016, medical records for all patients hospitalized for SISBH at 2 tertiary referral hospitals were retrospectively reviewed. The primary outcome was requirement for surgery.
Results
A total of 37 patients were enrolled. The mean age was 74.1 years. Among them, 33 patients (89.2%) were taking anticoagulant and/or antiplatelet agents. Duodenal intramural hematoma was detected in 4 patients (10.8%), jejunal in 16 (43.2%), and ileal in 17 (45.9%). Compared to jejunal and ileal involvement, duodenal intramural hematoma was significantly associated with high Charlson comorbidity index and low levels of white blood cells, hemoglobin, and platelets in the blood. SISBH in the duodenum was related to thrombocytopenia in 3 patients following systemic chemotherapy for malignancy. All patients with SISBH showed clinical improvement with conservative therapy. Mean length of hospital stay was 9.35 days. Independent predictors of a hospital stay of more than 7 days were body weight less than 60 kg (odds ratio [OR], 12.213; 95% confidence interval [CI], 1.755–84.998; P=0.011) and a history of cerebrovascular accidents (OR, 6.667; 95% CI, 1.121–39.650; P=0.037).
Conclusions
Compared to jejunal and ileal involvement, thrombocytopenia may result in spontaneous duodenal intramural hematoma among patients who are treated with systemic chemotherapy for malignancies. Patients with SISBH have excellent clinical outcomes with conservative therapy regardless of the anatomical location of the hematoma.

Citations

Citations to this article as recorded by  
  • Drug-Induced Spontaneous Intramural Hematoma of the Gastrointestinal Tract: A Real-World Pharmacovigilance Analysis
    Xuehong Wang, Min Luo, Wenyu Li, Yuqian Zhou
    Journal of Cardiovascular Pharmacology.2025; 85(4): 297.     CrossRef
  • Idiopathic Duodenal Hematoma: A Case Report and Literature Review
    Ebtesam Al-Najjar, Abdullah Esmail, Bayan Khasawneh, Saifudeen Abdelrahim, Maen Abdelrahim
    Reports.2025; 8(2): 73.     CrossRef
  • A Case of Direct-Acting Oral Anticoagulant-Induced Intramural Colon Hematoma Successfully Treated by Laparoscopic Surgery
    Daisuke Tomita, Shigeo Toda, Ryo Miyazaki, Shuichiro Matoba, Hiroya Kuroyanagi
    Cureus.2024;[Epub]     CrossRef
  • Spontaneous Intramural Small Bowel Hematoma in an Elderly Man with Multiple Myeloma
    Sigrid L. Williamson, Aishwarya Suresh, Adrian Ong
    The American Surgeon™.2023; 89(6): 2816.     CrossRef
  • Intramural duodenal hematoma: diagnosis and management of a rare entity
    Álvaro Pérez-Rubio, Juan Carlos Sebastián-Tomás, Sergio Navarro-Martínez, Marta Córcoles Córcoles, Carlos Domingo del Pozo
    Cirugía Española (English Edition).2023; 101(7): 515.     CrossRef
  • Hematoma intramural duodenal: diagnóstico y manejo de una entidad infrecuente
    Álvaro Pérez-Rubio, Juan Carlos Sebastián-Tomás, Sergio Navarro-Martínez, Marta Córcoles Córcoles, Carlos Domingo del Pozo
    Cirugía Española.2023; 101(7): 515.     CrossRef
  • Jejunal intramural haematoma in a captive African lion (Panthera leo)
    Richelle G. Butcher, Baukje Lenting, Alison S. Clarke, Kelly Buckle, Cristina Gans
    Veterinary Record Case Reports.2023;[Epub]     CrossRef
  • Spontaneous Duodenal Hematoma: A Rare Complication of Triple Antithrombotic Therapy Case Report
    Mazin N Habhab, Asad J Torabi, Julie M Clary, George E Revtyak
    Future Cardiology.2023; 19(2): 71.     CrossRef
  • Intestinal Spontaneous Intramural Hematoma Secondary to Anticoagulation Therapy: A Case Report
    Karim El Aidaoui, Wahib Lahlou, Abderrahim Bourial, Nawal Bouknani, Chafik El Kettani
    Cureus.2023;[Epub]     CrossRef
  • Intramural Hematoma of Gastrointestinal Tract in People with Hemophilia A and B
    Wei-Jung Teng, Ching-Huei Kung, Mei-Mei Cheng, Jia-Ruey Tsai, Chia-Yau Chang
    Journal of Clinical Medicine.2023; 12(9): 3093.     CrossRef
  • Endoscopic management of intramural spontaneous duodenal hematoma: A case report
    Giorgio Valerii, Vittorio Maria Ormando, Carlo Cellini, Luca Sacco, Carmelo Barbera
    World Journal of Gastroenterology.2022; 28(20): 2243.     CrossRef
  • Warfarin-induced spontaneous intramural small bowel hematoma presenting as an acute abdomen: A case report
    Ding-Han Chen, Khay-Seng Soh, Ying-Tso Wang, Te-Chun Shen
    Medicine.2022; 101(35): e30335.     CrossRef
  • Spontaneous duodenal haematoma in a patient taking rivaroxaban
    Rebeca de Barros Lopes, Finn McLennan Battleday, Toby Calvert, Rob Gwynne‐Jones, Rebecca Thomas
    ANZ Journal of Surgery.2021;[Epub]     CrossRef
  • SPONTANEOUS INTRAMURAL SMALL-BOWEL HEMATOMA: A CAUSE OF ACUTE ABDOMEN IN ANTICOAGULATED PATIENTS
    Sergio Gil Rojas, Luis Miguel Estela Villa, Elsa María Jiménez Vicente
    Revista Española de Enfermedades Digestivas.2021;[Epub]     CrossRef
  • Small Bowel Obstruction
    Allison A. Aka, Jesse P. Wright, Teresa DeBeche-Adams
    Clinics in Colon and Rectal Surgery.2021; 34(04): 219.     CrossRef
  • Double Trouble: Spontaneous Duodenal Hematoma of Pancreatic Origin
    Luísa Martins Figueiredo, David Valadas Horta, Jorge A. Reis
    GE - Portuguese Journal of Gastroenterology.2019; 26(6): 458.     CrossRef
  • 28,549 View
  • 256 Download
  • 18 Web of Science
  • 16 Crossref
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