(1) Background: Gastroduodenal perforation (GDP) is a life-threatening condition caused by a spontaneous or traumatic event. Treatment should be based on the mechanism of damage, timing, location, extent of the injury, and the patient’s clinical condition. We aimed to examine several etiologic factors associated with gastroduodenal perforation and to search for the best method(s) for its prevention and treatment. (2) Methods: We conducted extensive literature reviews by searching numerous studies obtained from PubMed, Science Direct, and Cochrane for the following keywords: gastroduodenal perforation, Helicobacter pylori, NSAIDs’ use, side effects of GDP, laparoscopy, and surgery. The primary outcome was the reported occurrence of GDP. (3) Results: Using keywords, 883 articles were identified. After applying the inclusion and exclusion criteria, 53 studies were eligible for the current analyses, with a total number of 34,692 gastroduodenal perforation cases. Even though the risk factors of gastroduodenal perforation are various, the prevalence of H. pylori among patients with perforation is considerably high. As technology develops, the treatment for gastric perforation will also improve, with laparoscopic surgery having a lower mortality and complication rate compared to open surgery for GDP treatment. (4) Conclusions: H. pylori infection plays the most significant role in GDP, more than NSAIDs, surgery, chemotherapy, or transplantation. Treatment of H. pylori infection is essential to decrease the prevalence of GDP and speed up its recovery. However, urgent cases require immediate intervention, such as laparoscopic or open surgery.

Amie Vidyani, Citra Indriani Sibarani, Budi Widodo, Herry Purbayu, Husin Thamrin, Muhammad Miftahussurur, Poernomo Boedi Setiawan, Titong Sugihartono, Ulfa Kholili and Ummi Maimunah. Korean J Gastroenterol 2024;83:45-53. https://doi.org/10.4166/kjg.2023.107

Esophageal stricture is a narrowing of the esophageal lumen which is often characterized by impaired swallowing or dysphagia. It can be induced by inflammation, fibrosis or neoplasia which damages the mucosa and/or submucosa of the esophagus. Corrosive substance ingestion is one of the major causes of esophageal stricture, particularly in children and young adults. For instance, accidental ingestion or attempted suicide with corrosive household products is not uncommon. Gasoline is a liquid mixture of aliphatic hydrocarbons derived from the fractional distillation of petroleum, which is then combined with additives such as isooctane and aromatic hydrocarbons (e.g., toluene and benzene). Gasoline also contains several other additives including ethanol, methanol and formaldehyde, which make it a corrosive agent. Interestingly, to the best of our knowledge, the incidence of esophageal stricture caused by chronic gasoline ingestion has not been reported. In this paper, we report the case of a patient with dysphagia due to complex esophageal stricture due to chronic gasoline ingestion who underwent a series of esophago-gastro-duodenoscopy (EGD) procedures and repeated esophageal dilation.

Introduction: Non-Hodgkin lymphoma of the duodenum with manifestation of hematemesis, melena, and obstructive jaundice is a rare occurrence. Case presentation: A 47-year-old Indonesian man presented with symptoms of hematemesis of 3×/day, melena, abdominal pain, decreased appetite, and a weight loss (2 kg). The patient had symptoms of weakness, jaundice, pale conjunctiva, and experienced palpable discomfort in the epigastric region (VAS of 6). An abdominal ultrasonography revealed a heterogeneous cystic tumor mass measuring 45 × 29 mm located in the pancreas head. The gastrointestinal endoscopy revealed erosive gastritis and a tumor in the duodenum. The patient received a biliodigestive surgery and biopsy for double bypass. The pathological anatomy findings indicated the presence of non-Hodgkin lymphoma. The immunohistochemical results showed that the tumor cells were positive for CD45, CD20, and Ki67 95 % but negative for CK and CD3. The patient had a series of chemotherapy treatments include RCHOP, ICE, and EPOCH for a duration of 1½ years. Subsequently, the patient was assessed and pronounced to be cured. Discussion: The identification of diffuse large B-cell lymphoma (DLBCL) from duodenum in this case was challenging due to the presence of unspecific symptoms such as hematemesis, melena, and obstructive jaundice. Management of DLBCL involved surgical interventions and sequential chemotherapy, which have shown the most significant enhancement in prognosis. Conclusion: The diagnostic accuracy of DLBCL from duodenal site enhances the effectiveness of the therapy employed, leading to a favorable prognosis. Highlights:

Transjugular intrahepatic portosystemic shunt (TIPS) represents a groundbreaking innovation in managing complications of portal hypertension, such as variceal bleeding and refractory ascites. This minimally invasive procedure creates a direct connection between the portal and systemic circulation, reducing portal pressure and improving hemodynamic stability. Over the years, advances in imaging techniques, stent technology, and procedural approaches have transformed TIPS from an experimental concept into a standard-of-care intervention. This review explores the translational journey of TIPS, highlighting its scientific underpinnings, clinical applications, and evolving role in hepatology. Key milestones in preclinical research that laid the foundation for its success are discussed, alongside its adoption in clinical practice and its impact on patient outcomes. While TIPS has revolutionized treatment paradigms, challenges remain, including complications such as hepatic encephalopathy and stent dysfunction. Emerging innovations in stent design and patient monitoring hold promise for overcoming these barriers and expanding the scope of TIPS in therapeutic medicine.