Patients with Inflammatory Bowel Disease (IBD) are at increased risk of psychological and physical burden, including sexual dysfunction (SD). This study aimed to assess the prevalence of SD and to identify its predictive factors, in IBD patients. This unicentric cross-sectional case-control survey (ratio 2:1) included patients followed at the day hospital IBD consultation, in the Gastroenterology department of a tertiary referral center, for 2 years. Participants received anonymous questionnaires, concerning basic characteristics and sexual function, and a questionnaire on anxiety and depression, body image, fatigue, and IBD-specific health-related quality of life (QoL). We analyzed data from 120 IBD patients and 60 healthy controls. Forty-two female (56.8%) and 6 male (14.6%) IBD patients, and 6 women (15%) and 2 males (10%) of the control group presented SD. SD was significantly higher in IBD patients with age between 18 and 30 and 51 and 60 than in healthy controls (
P
< .05) Regarding multivariate analysis, age was a predictive factor for SD in males (
P
= .014), and anxiety and depression (
P
= .002) and fatigue (
P
= .043) in females. SD is a predictor of lower QoL among IBD patients, considering the last 15 (
P
< .001) and 60 days (
P
= .001), regarding univariate analysis. SD (
P
= .007), body image distortion (
P
< .001), and fatigue (
P
= .004) were predictors of low QoL (last 15 days, multivariate analysis). SD was more prevalent in IBD patients than in the control group and impacted negatively the QoL of patients. Age was a predictive factor for SD in men while anxiety and depression, and fatigue were predictive of SD in women.
Endometriosis is a relatively common gynecological condition in women of reproductive age. The rectosigmoid region is the most commonly affected segment when the gastrointestinal tract is involved. A differential diagnosis of colorectal neoplasia is difficult because of the similar clinical, endoscopic, and radiology findings. A 42-year-old female presented with abdominal distention and was subsequently diagnosed with a large bowel obstruction in the rectum. A temporary colostomy was performed, and endoscopy revealed a rectal mass obstructing the rectum. The biopsy showed normal mucosa, and it was difficult to exclude rectal malignancies even after the imaging workup. Endoscopic ultrasound demonstrated a hypoechoic lesion below the rectal mucosa, and fine needle aspiration confirmed the diagnosis of bowel endometriosis. Bowel endometriosis is a challenging diagnosis. Endoscopic ultrasound-guided fine-needle aspiration is useful for acquiring adequate samples for histological confirmation and a definitive diagnosis of bowel endometriosis.
We report a case of a 72-year-old man with a signet-ring gastric antrum adenocarcinoma that underwent total gastrectomy with Y-de-Roux procedure. The surgery was complicated by a severe dehiscence of the esophagojejunal anastomosis with perianastomotic abscess a week later. Endoscopic treatment was not considered feasible at the time. The patient underwent surgical drainage of the perianastomotic abscess, was started on broadspectrum antibiotics and a jejunostomy was performed for feeding. Clinical evolution was favorable and endoscopic reevaluation after two months revealed an improvement of the anastomotic dehiscence, with only a 10 mm orifice remaining (FIGURE 1). In this regard, it was decided to place a fully covered self-expandable metallic stent, anchoring its proximal end with an over-the-scope clip (OTSC). Both stent and OTSC positions were confirmed by
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