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Khafaji RA, Ghandourah HS, Altamimi SK, Alwarthan AA, Alhabib RA, Alaiyar MN, Alomar IA, Alayshan MI, Almasoudi MS, Jaml Allil HA, Munshi SZ, Aljamri SK, Bagadeem BS, Attar MS, Al-Hawaj F. Retraction: Epiploic Appendagitis Clinically Masquerading as an Acute Diverticulitis. Cureus 2024; 16:r109. [PMID: 38274617 PMCID: PMC10809893 DOI: 10.7759/cureus.r109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
[This retracts the article DOI: 10.7759/cureus.20188.].
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Affiliation(s)
| | | | | | - Afnan A Alwarthan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | | | | | | | | | | | - Hashem A Jaml Allil
- College of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | | | - Sarah K Aljamri
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Basil S Bagadeem
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Motaz S Attar
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Faisal Al-Hawaj
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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Sanai FM, Alhouthali AH, Alghamdi HS, Badriq F, Sanai EA, Mujalled MK, Khayyat W, Attar MS, Bagadeem BS, Meer AM, Alshumrani W, Albeladi K, AlTraif I, Alqahtani S. Lower prevalence of hepatic fibrosis in low viremic hepatitis B patients with fluctuating HBV DNA levels. Saudi J Gastroenterol 2022; 28:341-347. [PMID: 35488588 PMCID: PMC9752532 DOI: 10.4103/sjg.sjg_48_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND In chronic hepatitis B virus (HBV) patients, fluctuations in HBV DNA serve as a "gray area" and impede the accurate identification of inactive carriers. We aimed to assess if such fluctuations impact the presence of significant hepatic fibrosis (Metavir F2-4) in chronic HBV patients. METHODS Consecutive, untreated HBeAg-negative carriers (n = 234) with fluctuating HBV DNA (n = 73) above or below a level of 2000 IU/mL were included and compared to those without fluctuations (n = 161). Patients without fluctuating HBV DNA were further analyzed based on those with persistently low (<2,000 IU/mL, n = 137) and higher HBV DNA (2,000-20,000 IU/mL, n = 24). Hepatic fibrosis (assessed by transient elastography) was correlated with virologic and biochemical profiles. RESULTS The mean age of the overall cohort was 47.8 ± 11.1 years, of whom 107 (45.7%) were male. During a median of 60 months (interquartile range [IQR] 34-82) of follow-up, 73 (31.2%) patients had a mean of 1.6 ± 0.9 fluctuations in HBV DNA. The median time to the first fluctuation was at 14.5 (IQR 5.0-33.7) months. Patients with fluctuating viremia had higher log10 qHBsAg (3.1 ± 0.8 vs. 2.7 ± 1.0, P = 0.022) and HBV DNA (3.4 ± 0.5 vs. 2.7 ± 0.8, P < 0.001) compared to those without fluctuations. Patients with fluctuant viremia were less likely to have F2-4 fibrosis (8.2%) compared to those without fluctuant viremia (18.2%, odds ratio [OR]: 0.407, 95% confidence interval [CI]: 0.161-1.030; P = 0.052). Males tended to have less fluctuation constituting 37.0% of patients with fluctuating HBV DNA (P = 0.071). Fluctuations occurred more frequently in those with predominantly higher HBV DNA levels (26.0%) compared to those without fluctuations (14.9%; P = 0.030). CONCLUSIONS Fluctuating HBV DNA levels occur frequently but are not associated with significant fibrosis. Minor fluctuations in HBV DNA levels are unlikely to be of clinical relevance.
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Affiliation(s)
- Faisal M. Sanai
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia,Address for correspondence: Dr. Faisal M. Sanai, Gastroenterology Unit, Department of Medicine, King Abdulaziz Medical City, PO Box 22490, Jeddah - 21423, Saudi Arabia. E-mail:
| | - Ahmad H. Alhouthali
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Hamdan S. Alghamdi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia,Department of Hepatobiliary Sciences and Organ Transplant Center, Division of Hepatology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Feras Badriq
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Eisa A. Sanai
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Mohammed K. Mujalled
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Waleed Khayyat
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Motaz S. Attar
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Basil S. Bagadeem
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Alaa M. Meer
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Waleed Alshumrani
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia,College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Khalid Albeladi
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Ibrahim AlTraif
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia,Department of Hepatobiliary Sciences and Organ Transplant Center, Division of Hepatology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Saleh Alqahtani
- Liver Transplant Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia,Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
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Khafaji RA, Ghandourah HS, Altamimi SK, Alwarthan AA, Alhabib RA, Alaiyar MN, Alomar IA, Alayshan MI, Almasoudi MS, Jaml Allil HA, Munshi SZ, Aljamri SK, Bagadeem BS, Attar MS, Al-Hawaj F. Epiploic Appendagitis Clinically Masquerading as an Acute Diverticulitis. Cureus 2022; 14:x31. [PMID: 35463590 PMCID: PMC8996737 DOI: 10.7759/cureus.x31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Khafaji RA, Ghandourah HS, Altamimi SK, Alwarthan AA, Alhabib RA, Alaiyar MN, Alomar IA, Alayshan MI, Almasoudi MS, Jaml Allil HA, Munshi SZ, Aljamri SK, Bagadeem BS, Attar MS, Al-Hawaj F. Epiploic Appendagitis Clinically Masquerading as an Acute Diverticulitis. Cureus 2021; 13:e20188. [PMID: 35004011 PMCID: PMC8727498 DOI: 10.7759/cureus.20188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2021] [Indexed: 11/22/2022] Open
Abstract
Acute diverticulitis is a prevalent surgical condition that typically presents with lower abdominal pain and tenderness. However, the clinical and laboratory findings of diverticulitis are non-specific and other conditions may give similar manifestations. We present the case of a middle-aged woman with a left lower quadrant abdominal pain and fever of three days duration. On examination, she had tachycardia and localized tenderness in the left iliac fossa with rebound tenderness. There were no signs of peritonitis, including the rigid abdomen and decreased bowel sounds. The laboratory findings were suggestive of an inflammatory or infectious process. A computed tomography scan of the abdomen demonstrated a fat-density lesion anterior to the descending colon representing epiploic appendagitis. The patient was managed conservatively with non-steroidal anti-inflammatory drugs (lornoxicam 8 mg). The patient experienced gradual improvement and was discharged after four days of hospitalization. No surgical intervention was needed. The case highlighted the importance of considering epiploic appendagitis in the differential diagnosis of acute diverticulitis. An accurate diagnosis will prevent the patient from having unnecessary surgeries as conservative management is often sufficient in patients with epiploic appendagitis.
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Affiliation(s)
| | | | | | - Afnan A Alwarthan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | | | | | | | | | | | - Hashem A Jaml Allil
- College of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | | | - Sarah K Aljamri
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Basil S Bagadeem
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Motaz S Attar
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Faisal Al-Hawaj
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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