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Background and study aims: Endoscopy plays an essential role in managing patients with ulcerative colitis (UC), as it allows us to visualize and assess the severity of the disease. As such assessments are not always objective, different scores have been devised to standardize the findings. The main aim of this study was to assess the interobserver variability between the Mayo Endoscopy Score (MES), Ulcerative Colitis Endoscopy Index of Severity (UCEIS) and Ulcerative Colitis Colonoscopy Index of Severity (UCCIS) analyzing the severity of the endoscopic lesions in patients with ulcerative colitis. Patients and methods: This was a single-cohort observational study in which a colonoscopy was carried out on patients with UC, as normal clinical practice, and a video was recorded. The results from the video were classified according to the MES, UCEIS and UCCIS by three endoscopic specialists independently, and they were compared to each other. The Mayo Endoscopy Score (MES) was used to assess the clinical situation of the patient. The therapeutic impact was analyzed after colonoscopy was carried out. Results: Sixty-seven patients were included in the study. The average age was 51 (SD ± 16.7) and the average MES was 3.07 (SD ± 2.54). The weighted Kappa index between endoscopists A and B for the MES was 0.8; between A and C 0.52; and between B and C 0.49. The intraclass correlation coefficient for UCEIS was 0.92 among the three endoscopists (CI 95 %: 0.83–0.96) and 0.96 for UCCIS among the three endoscopists (CI 95 % 0.94–0.97). A change in treatment for 34.3 % of the patients was implemented on seeing the results of the colonoscopy. Conclusions: There was an adequate, but not perfect, correlation between the different endoscopists for MES, UCEIS, UCCIS. This was higher with the last two scores. Thus, there is still some subjectivity to be minimized through special training, on assessing the seriousness of the endoscopic lesions in patients with UC.

A new subcutaneous formulation of the infliximab biosimilar CT-P13 has recently been developed for the treatment of inflammatory bowel disease (IBD), providing response rates similar to intravenous treatment. In an effort to limit patient attendance at intravenous infusion centers and to maintain biological treatment during the COVID-19 pandemic, the use of this new formulation was requested. The objective of this observational, retrospective, and descriptive study was to assess CT-P13 efficacy and safety after switching from intravenous to subcutaneous formulation in patients with IBD receiving maintenance therapy. This article shows preliminary results after six months of follow-up.

Introduccion: la endoscopia tiene un papel fundamental en el manejo de los pacientes con colitis ulcerosa (CU), ya que permite la visualizacion y evaluacion de la gravedad de la enfermedad. No obstante, dicha evaluacion no es siempre algo objetivo, por lo que se han desarrollado diferentes escalas que pretenden homogeneizar los hallazgos. Objetico: el objetivo del estudio fue evaluar la variabilidad interobservador entre el Indice de Mayo Endoscopico (IME) y el Indice de Severidad Endoscopica de la Colitis Ulcerosa (UCEIS), al analizar la gravedad de las lesiones endoscopicas en pacientes con CU. El objetivo secundario fue analizar si la preparacion catartica afectaba al grado de concordancia entre los endoscopistas. Material y metodos: se trata de un estudio observacional comparativo de una unica cohorte a la cual se realiza una colonoscopia bajo guia de practica clinica habitual a pacientes con CU y se estadifica segun el IME y el UCEIS por tres endoscopistas expertos. Para valorar el grado de correlacion interobservador se utilizaron el indice de Kappa para el IME y el coeficiente de correlacion intraclase para el UCEIS. Se incluyeron 67 pacientes, con edad media de 51 anos (DE ± 16,7) e indice de Mayo clinico medio de 3,07 (DE ± 2,54). Resultados: el indice de Kappa ponderado entre los endoscopistas A y B para el IME fue de 0,8; entre el A y el C, de 0,52; y entre el B y el C, de 0,49. Para el UCEIS, el coeficiente de correlacion intraclase fue del 0,922 entre los tres endoscopistas (IC 95 %: 0,832-0,959). Se encontro una mejor correlacion interobservador cuando la preparacion catartica era ≥ 8 segun la escala de Boston. Conclusion: existe, por tanto, una superior correlacion entre los diferentes endoscopistas para el UCEIS que para el IME, por lo que deberia ser considerado como el mejor indice a utilizar en la practica clinica. Una buena preparacion catartica es importante para mejorar la correlacion interobservador.

Introduccion y objetivos: la pandemia por el SARS-COV2 ha obligado a un cambio sustancial en la atencion a los pacientes con patologias digestivas, en especial a los pacientes con enfermedad inflamatoria intestinal (EII), por estar tratados con farmacos inmunomoduladores. En este sentido, algunas guias nacionales e internacionales han indicado las normas a tener en cuenta. No obstante, pocos trabajos han evaluado como han afrontado los pacientes esta infeccion. Por ello, hemos realizado este estudio con el objetivo de conocer como ha afectado la pandemia por SARS-COV2 a nuestros pacientes con EII. Material y metodos: se realizo una encuesta on-line entre los 295 miembros de la Asociacion de Enfermos de Crohn y Colitis Ulcerosa (ACCU) que constaba de 19 preguntas. Resultados: participaron 168 pacientes de la ACCU, de los cuales un 58 % eran mujeres, el 63,7 % tenia una EC y el 53 % recibia tratamiento biologico. Un 5 % fueron infectados por el SARS-CoV2, todos ellos varones. La principal preocupacion de los pacientes era el miedo a adquirir la infeccion (80,9 %). Mas del 90 % continuo con su tratamiento inmunosupresor y biologico. La mitad de los pacientes teletrabajaron durante el periodo de pandemia. Conclusiones: la perspectiva de los pacientes es fundamental para conseguir un adecuado manejo y evolucion de la enfermedad. Son necesarios mas trabajos que evaluen el impacto que situaciones excepcionales como la pandemia COVID-19 puede ocasionar sobre los pacientes con EII para mejorar la adherencia y el control de la enfermedad.

Splenosis is an uncommon pathology whose diagnosis requires a high index of suspicion. In most cases they are incidental findings, so their suspicion is essential to carry out a non-invasive diagnosis. We present a case of intraabadominal splenosis and perform a brief review of the literature.

Background: vedolizumab is an α4β7 integrin antagonist. The aim of this study was to evaluate the clinical response and remission rates with vedolizumab. Methods: this was a retrospective study of inflammatory bowel disease (IBD) patients who received vedolizumab between 2016 and 2019. Response and remission rates were analyzed at three, six, 12, 18 and 24 months after induction. Results: fifty-five patients were included. Clinical remission rates in CD and UC at three, six, 12, 18 and 24 months were 19.35 %, 26.67 %, 30.43 %, 30 %, 38.89 % and 29.17 %, 26.09 %, 19.05 %, 26.67 % and 20 %, respectively. Conclusions: vedolizumab is effective for induction and maintenance of clinical remission, both in Crohn’s disease and ulcerative colitis.

Neuroendocrine tumors rarely occur in the esophagus because the neuroendocrine system is not well developed in the esophagus. The case of a neuroendocrine esophageal tumor developed in a patient with Barret's esophagus is presented. It was successfully trated by endoscopy.

Background: Several studies have reported positive efficacy outcomes for patients with inflammatory bowel disease treated with CT-P13, an infliximab biosimilar. Data from follow-up periods longer than 1 year are still scarce. Here, we assessed the long-term efficacy data, loss of response and safety after switching from infliximab to CT-P13 in patients with inflammatory bowel disease. Methods: This was a prospective single-center observational study involving patients with moderate-to-severe Crohn’s disease and ulcerative colitis switched from infliximab to CT-P13 treatment and reviewed up to 24 months. Efficacy and loss of response were measured using the Harvey–Bradshaw (HB) index and partial Mayo score for patients with Crohn’s disease and ulcerative colitis respectively. C-reactive protein, infliximab drug levels, adverse events and antidrug antibodies were also monitored throughout the study. Results: A total of 64 patients with Crohn’s disease and 36 patients with ulcerative colitis were included. Most of them (72%) remained on CT-P13. Overall, 28% of patients discontinued the therapy due to loss of response, adverse events or long-lasting clinical remission. Remission at 18 and 24 months occurred in 69.9% and 68.5% of patients, respectively. Dose increase was performed in 22% of patients, with remission being reached in 60% of them. HB index, partial Mayo score, C-reactive protein and infliximab drug levels did not show significant changes. Serious adverse events were reported in 14% of patients. Overall, two patients developed low levels of antidrug antibodies. Conclusions: Most of the patients switching from original infliximab were maintained on CT-P13 at 2 years of follow up with a good profile of efficacy and safety.

Small intestine hemangiomas are benign vascular tumors that usually present with occult gastrointestinal bleeding. Endoscopic capsule and enteroscopy are two tools that help in your preoperative diagnosis.