bmj-2025-079050.full.pdf
884.9 KB
State of the art review : Medical management of inflammatory bowel diseases.
BMJ 19,December 2025
❤5
Pancreas divisum is the most common pancreatic congenital abnormality, seen in approximately 6% of persons. It occurs when the ducts of the dorsal and ventral parts of the pancreas fail to fuse during embryonic development. As a result, the two parts of the pancreas maintain distinct drainage into the duodenum. The majority of secretions enter the duodenum by way of the dorsal duct, which enters the duodenum at the smaller minor papilla; the ventral duct drains a smaller part of the pancreas and enters the duodenum at the major papilla.
Most patients with pancreas divisum are asymptomatic. It seems likely, although unproven, that a small subgroup of patients present with recurrent episodes of pancreatitis, thought to be due to the small caliber of the minor papilla, leading to obstruction and subsequent pancreatitis.
The treatment of incidental pancreas divisum is observation.
Most patients with pancreas divisum are asymptomatic. It seems likely, although unproven, that a small subgroup of patients present with recurrent episodes of pancreatitis, thought to be due to the small caliber of the minor papilla, leading to obstruction and subsequent pancreatitis.
The treatment of incidental pancreas divisum is observation.
❤2
✳️ The most appropriate management step for a patient who is found to have a gastric residual of 100 mL after starting on enteral feeding through a percutaneous gastrostomy tube is to elevate the head of the bed and continue the tube feeding.
The combination of fever, diabetes, abnormal liver function tests, and a hypoechoic hepatic lesion on ultrasound is consistent with pyogenic liver abscess. Broad-spectrum IV antibiotics should be initiated immediately to provide coverage for anaerobes, gram-negative bacteria, and gram-positive cocci.
For large abscesses, percutaneous drainage is indicated, which requires interventional radiology consult for image-guided catheter placement.
For large abscesses, percutaneous drainage is indicated, which requires interventional radiology consult for image-guided catheter placement.
👍1
One_vs_Five_Days_of_Octreotide_Infusion_for_Acute_Esophageal_Variceal.pdf
1.1 MB
One vs Five Days of Octreotide Infusion for Acute Esophageal Variceal Bleeding: A Randomized Controlled Trial
AJG 25 December 2025
Correlation_between_virological_response_and_portal_vein_thrombosis.pdf
2.4 MB
Correlation between virological response and portal vein thrombosis in patients with chronic hepatitis B
❤1👍1
🔥 Hot From the Press | Clinical Pearl
Acute Severe UC: Early infliximab exposure matters.
🔹 Day-3 infliximab ≤57.9 µg/mL predicts:
🤜 Day-14 failure
🤜3-month colectomy
🔹 High infliximab clearance drives non-response — but can be overcome with intensified dosing (10 mg/kg).
⚠️ Limitations:
• Real-world TDM turnaround may be delayed
• Clearance not easily calculated at bedside
• Observational PK analysis
Acute Severe UC: Early infliximab exposure matters.
🔹 Day-3 infliximab ≤57.9 µg/mL predicts:
🤜 Day-14 failure
🤜3-month colectomy
🔹 High infliximab clearance drives non-response — but can be overcome with intensified dosing (10 mg/kg).
⚠️ Limitations:
• Real-world TDM turnaround may be delayed
• Clearance not easily calculated at bedside
• Observational PK analysis