Fernando Castro-Pavia

Computed tomography findings of spontaneous porto-pulmonary shunts in 3 patients with portal hypertension.

Spontaneous portopulmonary shunts in the setting of cirrhosis have been associated with the embolization of gelfoam during the treatment of esophageal varices, resulting in strokes. Currently there is minimal data describing the prevalence of spontaneous portopulmonary shunts. Our aim is to demonstrate computed tomography (CT) imaging findings of spontaneous portopulmonary venous anastomoses in patients with underlying portal hypertension. Clinical cases with accompanying CT images are presented and described. A review of the literature is discussed. CT is a useful method for identifying shunting, both spontaneous and surgical, of the portal circulation secondary to hypertension. A less known type of anastomosis involves the pulmonary circulation, specifically the pulmonary veins and left atrium, that can also be recognized with CT.

Evaluation of the effect of GLP‐1 agonists on quality of bowel preparation for colonoscopy in patients with diabetes

People with diabetes mellitus warrant a greater need for colonoscopy owing to the increased risk of colorectal cancer and autonomic neuropathy. Unfortunately, this population is reported to have a higher proportion of inadequate bowel preparation during colonoscopy, which translates into lower adenoma detection rates and repeat colonoscopies. Glucagon‐like peptide‐1 (GLP‐1) agonists commonly used in the management of diabetes are well known to cause delayed gastrointestinal (GI) transit times, yet it is unknown if they contribute to the higher frequency of inadequate bowel preparation in people with diabetes.