Abhilash Perisetti

Kansas City VA Medical Center · Department of Gastroenterology

A new coronavirus emerged in December 2019 in Wuhan city of China, named as the severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), and disease was called as coronavirus disease‐2019 (COVID‐19). The infection due to this virus spread exponentially throughout China and then spread across >205 nations, including the United States (US). Gast...

Primary liver cancers carry significant morbidity and mortality. Hepatocellular carcinoma (HCC) develops within the hepatic parenchyma and is the most common malignancy originating from the liver. Although 80% of HCCs develop within background cirrhosis, 20% may arise in a non-cirrhotic milieu and are referred to non-cirrhotic-HCC (NCHCC). NCHCC is...

Telemedicine involves delivering healthcare and preventative care services to patients without the need for in-person encounters. Traditionally, telemedicine has been used for acute events (e.g., stroke, used to relay essential information to the emergency department) and chronic disease management (e.g., diabetes and chronic kidney disease managem...

Background: End-stage renal disease (ESRD) patients are highly susceptible to peptic ulcer bleeding (PUB). We aimed to assess the influence of ESRD status on PUB hospitalizations in the United States (USA). Methods: We analyzed the National Inpatient Sample to identify all adult PUB hospitalizations in the USA from 2007 to 2014, which were divided...

Liver disease is one of the leading public health problems faced by healthcare practitioners regularly. As such, there has been a search for an inexpensive, readily available, non-invasive marker to aid in monitoring and prognosticating hepatic disorders. Recently, red blood cell distribution width (RDW) has been found to be associated with various...

Background and aims Greenhouse gases (GHGs) that trap heat in the atmosphere are composed of carbon dioxide (CO 2 ), methane, nitrous oxide and fluorinated gases (synthetic hydrofluorocarbons, perfluorocarbons and nitrogen trifluoride). In the USA, the health sector accounts for 8.5% of total GHG emissions. The primary objective of this systematic...

Introduction: Endoscopic full-thickness resection (EFTR) is a promising technique that allows for a minimally invasive resection of mucosal and submucosal lesions in the gastrointestinal (GI) tract. The data regarding the efficacy and safety of performing EFTR of upper GI lesions using a full-thickness resection device (FTRD) is limited. Hence, we...

Introduction: Peptic ulcer bleeding (PUB), a life-threatening complication of peptic ulcer disease, has been regarded as a leading cause of upper gastrointestinal bleeding globally. Studies have reported higher rates of PUB in patients with end-stage renal disease (ESRD) secondary to a cluster of complex pathophysiological mechanisms. In this stud...

Introduction: Nonalcoholic fatty liver disease (NAFLD) is rapidly emerging as one of the most common causes of chronic liver disease worldwide and in the United States (US), primarily secondary to the obesity epidemic, rising prevalence of diabetes mellitus, and an aging population. Although peptic ulcer disease (PUD) is commonly seen in patients...

Introduction: The global age-adjusted standardized incidence and prevalence rates of peptic ulcer disease (PUD) have declined over the last few decades. Nonetheless, studies have reported higher rates of PUD and its complications in patients with chronic liver disease. However, there continues to be a significant paucity of data on the impact of n...

Introduction: Hiatal Hernia (HH) is characterized by the displacement of abdominal viscera into the mediastinum. It is usually an incidental finding on imaging or endoscopy, but may present with non-specific clinical signs and symptoms, often linked to gastroesophageal reflux disease (GERD). However, some patients may develop cardiac complications...

Introduction: Spontaneous Bacterial Peritonitis (SBP) is a serious acute bacterial infection of the ascitic fluid usually seen in patients with liver cirrhosis. Despite aggressive use of prophylactic antibiotics, it is often associated with poor clinical outcomes and subsequent hospital readmissions. In this study, we aimed to assess and compare 3...

Introduction: Achalasia is a neurodegenerative motility disorder of the esophagus characterized by ineffective lower esophageal sphincter (LES) relaxation and peristalsis leading to progressive dysphagia. Per-Oral Endoscopic Myotomy (POEM) is a rapidly emerging minimally invasive procedure for management of achalasia. In this study, we aimed to in...

Background/Aims: We aim to assess the influence of obesity on gastroparesis (GP) hospitalizations in the United States (US). Methods: The National Inpatient Sample was analyzed from 2007-2017 to identify all adult hospitalizations with a primary discharge diagnosis of GP. They were subdivided based on the presence or absence of obesity (body mass i...

Background and aim: A few recent studies identified cirrhosis as a risk factor for high mortality in patients with coronavirus disease-19 (COVID-19). Palliative care is less often involved in the management of cirrhosis. We analyzed a global multicenter database to study the risk of mortality and palliative care referrals in patients with COVID-19...

Background We identified trends of inpatient therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in the United States (US), focusing on outcomes related to specific patient demographics.Methods The National Inpatient Sample was utilized to identify all adult inpatient ERCP in the US between 2007–2018. Trends of utilization and adverse...

Background and aim: Early readmissions of spontaneous bacterial peritonitis (SBP) are often associated with poor outcomes. We compared characteristics and outcomes for index and 30-day readmissions of SBP in the USA. Methods: We analyzed the Nationwide Readmissions Database for 2018 to identify all adult (≥ 18 years) 30-day readmissions of SBP i...

Background and study aims Post-ERCP pancreatitis (PEP) is the most common complication attributed to the procedure, its incidence being approximately 9.7 %. Numerous studies have evaluated the predictive efficacy of post-procedure serum amylase and lipase levels but with varied procedure-to-test time intervals and cut-off values. The aim of this me...

Background: Spontaneous bacterial empyema (SBE) occurs when a hepatic hydrothorax becomes infected and runs a course similar to spontaneous bacterial peritonitis (SBP). It remains underdiagnosed as patients with cirrhosis do not routinely undergo diagnostic thoracentesis. Current understanding is limited by small cohorts, while studies reporting i...

Background and study aims Duodenoscopes that are contaminated due to inadequate reprocessing are well-documented. However, studies have demonstrated poor reprocessing of other kinds of endoscopes as well, including echoendoscopes, gastroscopes, and colonoscopes. We estimated the contamination rate beyond the elevator of gastrointestinal endoscopes...

Background: This study aimed to assess the trends and characteristics of celiac disease (CeD) hospitalizations in the United States (US). Methods: The National Inpatient Sample was analyzed from 2007-2017 to identify all adult hospitalizations with a primary discharge diagnosis of CeD. Demographic trends, associations, and other aspects of CeD hosp...

In this article the author name ‘Dushyant Dahiya’ was incorrectly written as ‘Dushant Dahiya’.

Background: Colonic Volvulus (CV) is a frequent cause of benign large bowel obstruction, often needing emergent intervention to avoid fatal outcomes. Studies have reported rising incidence of CV in the United States (US) in the last decade. Methods: We utilized the National Inpatient Sample (NIS) from 2007–2017 to identify all adult (>18 years) hos...

Introduction: Postoperative bile leak are uncommon complication after laparoscopic cholecystectomy, which if not promptly recognized and managed can lead to significant morbidity and mortality. Endoscopic Retrograde Cholangiopancreatography (ERCP) with biliary sphincterotomy with or without stent placement is commonly performed for management of bi...

Introduction: Each year seven million of esophagogastroduodenoscopies (EGD) are performed in the United States (US). Moderate or conscious sedation is a pharmacologically induced decreased consciousness during which patients can respond to verbal commands, either alone or accompanied by tactile stimulation, with minimal or no interventions to main...

Background: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) has become the procedure of choice to obtain diagnostic samples for the lesions in the gastrointestinal tract and adjacent organs. Rapid onsite evaluation (ROSE) by a cytopathologist typically accompanies EUS-FNB to increase the diagnostic accuracy and efficacy of the procedure a...

BACKGROUND: The prevalence of Crohn’s disease (CD) and ulcerative colitis (UC) is on the rise worldwide. This rising prevalence is concerning as patients with CD and UC may frequently relapse leading to recurrent hospitalizations and increased healthcare utilization. AIM: To identify trends and adverse outcomes for 30 d readmissions for CD and UC....

Over 17.7 million gastrointestinal (GI) endoscopic procedures are performed annually, contributing to 68% of all endoscopic procedures in the United States. Usually, endoscopic procedures are low risk, but adverse events may occur, including cardiopulmonary complications, bleeding, perforation, pancreatitis, cholangitis, and infection. Infections a...

Background Pancreatic cancer (PC) is a highly fatal malignancy with a global overall 5-year survival of under 10%. Screening of PC is not recommended outside of clinical trials. Endoscopic ultrasonography (EUS) is a very sensitive test to identify PC but lacks specificity and is operator-dependent, especially in the presence of chronic pancreatitis...

Background/Objectives: Pancreatic cancer is the third leading cause of cancer death in the United States (US). However, there is paucity of data on pancreatic cancer hospitalizations in the US. Methods: We analyzed the National Inpatient Sample (NIS) to identify all hospitalizations of pancreatic cancer from 2008 to 2017. Hospitalization characteri...

Background and study aims: Injectable glucagon enables easier biliary cannulation by inhibiting gastrointestinal motility and decreasing the frequency and amplitude of phasic activity of the sphincter of Oddi during endoscopic retrograde cholangiopancreatography (ERCP). Data about the safety profile of glucagon use and patient clinical outcomes are...

Background: The aim of this study was to investigate obese gastroparesis (GP) hospitalizations in the United States (US). Methods: We analyzed the National Inpatient Sample (NIS) from 2007-2017 to identify all adult obese (body mass index ≥30 kg/m2) GP hospitalizations. These were compared with non-obese GP hospitalizations. The demographic trends,...

In the modern era of high-quality cross-sectional imaging, pancreatic cysts (PCs) are a common finding. The prevalence of incidental PCs detected on cross-sectional abdominal imaging (such as CT scan) is 3%–14% which increases with age, up to 8% in those 70 years or older. Although PCs can be precursors of future pancreatic adenocarcinoma, imaging...

Liver cancer is the second most occurring cancer worldwide and is one of the leading causes of cancer-related deaths. Hepatocellular carcinoma (HCC) is the most common (80%-90%) type among malignant liver cancers. Sarcopenia occurs very early in HCC and can predict and provide an opportunity to improve muscle health before engaging in the treatment...

Introduction: Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is causing dramatic morbidity and mortality worldwide. The Red Blood Cell Distribution Width (RDW) has been strongly associated with increased morbidity and mortality in multiple diseases. Objective: To assess if elevated RDW i...

Background/AimsWhile safety and effectiveness of advanced endoscopic resection techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) has been well established in general population, data regarding their utility in patients with cirrhosis is limited.Methods We searched multiple databases from inception thro...

Most colorectal cancers arise from adenomatous polyps and sessile serrated lesions. Screening colonoscopy and therapeutic polypectomy can potentially reduce colorectal cancer burden by early detection and removal of these polyps, thus decreasing colorectal cancer incidence and mortality. Most endoscopists are skilled in detecting and removing the v...

The introduction of capsule endoscopy in 2001 opened the last “black box” of the gastrointestinal tract enabling complete visualization of the small bowel. Since then, numerous new developments in the field of deep enteroscopy have emerged expanding the diagnostic and therapeutic armamentarium against small bowel diseases. The ability to achieve to...

Background: We aimed to evaluate the characteristics of hospitalizations for radiation proctitis (RP). Methods: The National Inpatient Sample (NIS) was analyzed to identify RP hospitalizations for 2016 and 2017. Outcomes included mortality, predictors of mortality, mean length of stay (LOS), mean total hospital cost (THC), and numerous system-ba...

The etiology of most cases of liver diseases in pregnancy can be diagnosed with a thorough history, physical examination, laboratory values, serology, and noninvasive imaging. However, atypical clinical and laboratory presentations of liver diseases/chemistries require a liver biopsy to render an accurate diagnosis in cases where the biopsy results...

The introduction of capsule endoscopy in 2001 opened the last ‘black box’ of the gastrointestinal tract enabling complete visualization of the small bowel. Since then, numerous new developments in the field of deep enteroscopy have emerged, expanding the diagnostic and therapeutic armamentarium against small bowel diseases. However, achieving total...

Gastrointestinal cancers are among the leading causes of death worldwide, with over 2.8 million deaths annually. Over the last few decades, advancements in artificial intelligence technologies have led to their application in medicine. The use of artificial intelligence in endoscopic procedures is a significant breakthrough in modern medicine. Curr...

Background Endoscopic procedures are performed commonly with moderate sedation. Obesity can pose a challenge in its safe administration. This study was aimed at assessing outcomes of endoscopy procedures performed with moderate sedation in obese patients. Patients and methods This was a retrospective study of patients undergoing esophagogastroduode...

With the progression of the COVID-19 pandemic, the classic manifestations of COVID-19 (e.g., persistent fever, dry cough, pneumonia, and acute respiratory distress syndrome in the severe disease) have expanded to include less common complications of the extrapulmonary organs. Recent evidence has shown that COVID-19 patients with concomitant presenc...

Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases encountered in primary care and gastroenterology clinics. Most cases of GERD can be diagnosed based on clinical presentation and risk factors; however, some patients present with atypical symptoms, which can make diagnosis difficult. An esophagogastroduodenos...

Endoscopic ultrasound (EUS) is one of the significant breakthroughs in the field of advanced endoscopy. In the last two decades, EUS has evolved from a diagnostic tool to a real-time therapeutic modality. The luminal gastrointestinal (GI) tract provides a unique opportunity to access multiple vascular structures, especially in the mediastinum and a...

Conclusion: Patients with greater comorbidity may be more likely to attend NRSC than not. Exact reasons for this are unclear but could include greater self-perceived risk of colorectal cancer (CRC) and increased interaction with the healthcare system. While past research has shown that patients with. 5 comorbidities are less likely to be screened f...

Background Splanchnic vein thrombosis is a well-recognized local vascular complication of acute pancreatitis (AP), estimated to occur in approximately 15% of patients. While splanchnic vein recanalization occurs spontaneously in approximately one third of patients, severe complications such as bowel ischemia and liver failure have also been reporte...

Background Direct-acting oral anticoagulants (DOACs) are increasingly used, with studies showing a lower risk of gastrointestinal bleeding (GIB), but overall data for GIB risk remains debatable. The objective was to assess non-fatal and fatal GIB risk in patients on DOACs compared with warfarin from randomized clinical trials (RCTs).Methods RCTs co...

Background and study aims Despite the clinical efficacy of peroral endoscopic myotomy (POEM), postoperative symptomatic gastroesophageal reflux disease (GERD) remains a major concern. While it is known that length of the gastric myotomy affects postoperative GERD, the clinical relevance of variation in esophageal myotomy length is not well known. W...

Background and objective Cirrhosis is the number one cause of non-cancer deaths among gastrointestinal diseases and is responsible for significant morbidity and healthcare utilisation. The objectives were to measure the 30-day readmissions rate following index hospitalisation, to determine the predictors of readmission, and to estimate the cost of...

Introduction: We aimed to assess the impact of socio-economic determinants of health (SEDH) on survival disparities within and between the ethnic groups of young-onset (<50 years age) colorectal adenocarcinoma patients. Patients and methods: Surveillance, epidemiology, and end results (SEER) registry was used to identify colorectal adenocarcinom...

Primary liver cancers carry significant morbidity and mortality. Hepatocellular carcinoma (HCC) develops within the hepatic parenchyma and is the most common malignancy originating from the liver. Although 80% of HCCs develop within background cirrhosis, 20% may arise in a non-cirrhotic milieu and are referred to non-cirrhotic-HCC (NCHCC). NCHCC is...