Systemic sclerosis (SSc) is a rare systemic autoimmune rheumatic disease frequently associated with gastrointestinal (GI) involvement. GI manifestations are heterogeneous, may occur throughout the entire tract from the very early stages of the disease and are often associated with a significant burden of symptoms and complications, leading to high morbidity and mortality. Diagnosis often remains challenging due to the lack of sensitive instruments for early detection and the reliance on invasive or expensive diagnostic tools. In recent years, ultrasound (US) has become an increasingly important tool for GI evaluation across a wide range of conditions, including chronic inflammatory bowel diseases, appendicitis and diverticulitis as well as rarer diseases and functional conditions. The aim of this scoping review is to provide an updated overview of the role of gastrointestinal ultrasound (GIUS) in the assessment and monitoring of GI involvement in SSc. A systematic search of MEDLINE and Scopus identified 25 eligible studies. The available evidence is unevenly distributed across the GI tract: thirteen studies addressed the upper GI tract, seven the anorectum, six the gallbladder and five the mesenteric vessels. For each segment, we summarize how US can detect changes in wall structure, vascularization and motility. The evidence base is limited by small, predominantly single-center and cross-sectional studies, heterogeneous acquisition protocols and reference standards and a scarcity of reproducibility data. Further prospective and multicenter studies are therefore needed to validate the role of GIUS, standardize protocols and establish its integration into the clinical management of SSc patients.

Most foreign body ingestions in adult patients pass spontaneously while sharp objects often require endoscopic intervention. Endoscopic foreign body removals are usually performed in the upper gastrointestinal (GI) tract, with few reports involving the lower GI tract. We present a case of a woman with recurrent nail ingestion who presented with abdominal pain after swallowing multiple nails. Initial conservative management demonstrated progressive migration, with eventual clustering near the ileocaecal valve. In this case, a cap-assisted colonoscopy was successfully used to remove all ingested nails.

Over the last few years upper gastrointestinal (GI) endoscopy has been proven to be an effective diagnostic and therapeutic tool for various gastrointestinal diseases in children. This retrospective study was done in a tertiary care center of Bangladesh for one year to assess the indications of upper GI endoscopy including the diagnostic and therapeutic yields for various gastrointestinal disorders in children. During this period, 211 patients, aged ≤16 years, referred either from outpatient clinics or admitted inpatient wards were enrolled in study and their demographic data, endoscopic details (indications, findings and any complications) were collected and normal and abnormal endoscopic findings were compared. Mean age was found 9.5±3.5 years. The most common indication of upper GI endoscopy was recurrent abdominal pain (24.1%) followed by upper gastrointestinal bleeding (20.4%). Normal upper GI endoscopy was found in 74.51% of patients who had recurrent abdominal pain and oesophageal varices were found in 51.16% of patients with upper gastrointestinal bleeding. Upper gastrointestinal bleeding, endoscopic surveillance of oesophageal varices, foreign body ingestion and screening for oesophageal varix in chronic liver disease patient were significantly associated with abnormal upper GI endoscopy findings with p value 0.005, 0.001, 0.019 and 0.001 respectively. This study showed that recurrent abdominal pain was associated with normal upper GI endoscopy result in majority cases, so it should be reserved as second line investigation in patients with recurrent abdominal pain. However, every child with upper gastrointestinal bleeding should be evaluated by upper GI endoscopy. Upper GI endoscopy should be chosen in a justifiable way in paediatric population considering the signs and symptoms of disease.

Obesity and intentional weight loss increasingly influence otolaryngologic disease through mechanical, metabolic, inflammatory, gastrointestinal, and regional soft-tissue effects. This review examines how bariatric surgery and contemporary medical weight-loss therapies affect the upper aerodigestive tract. Evidence is strongest for obstructive sleep apnea, in which substantial weight reduction improves disease severity but does not ensure remission. Emerging data suggest potential benefits for chronic rhinosinusitis and selected voice outcomes, alongside risks such as procedure-specific reflux, chronic cough, delayed gastric emptying, nutritional complications, and patulous Eustachian tube dysfunction. Otolaryngologists should incorporate the weight-loss method, magnitude, rate, and durability into evaluation, counseling, and perioperative planning.

Delayed gastric conduit emptying (DGCE) is a debilitating functional complication after esophagectomy. Because of a lack of large-scale outcome data, this project evaluated surgical revisional strategies for refractory DGCE within a recently published mechanism-informed classification system. REvisional Surgery for delayed gasTRic conduit emptying (RESTORANT) was a multicentric, retrospective cohort study including adult patients undergoing revisional surgery for DGCE from January 1, 2015, to December 31, 2024, across 26 high-volume centers that performed 11,807 esophagectomies during this period. Patients were eligible irrespective of the date of their index esophagectomy. Interventions were stratified into Class 1 (pylorus-related, C1), Class 2 (conduit-related, C2), and Class 3 (hiatus-related/paraconduit hernia, C3), with class assigned retrospectively according to the revisional procedure performed. The primary endpoint was reported symptom resolution. A total of 196 patients underwent 263 surgical interventions for DGCE. Sustained symptom relief was comparable across all classes: C1 (47.2%), C2 (58.2%), and C3 (63.9%; P = 0.165). For C1, pyloroplasty (47.6%) and Roux-en-Y diversion (46.7%) showed similar efficacy. In C2, conduit replacement (75.0%) and remodeling (61.3%) were significantly more effective than simple mobilization (50.0%; P = 0.035). For C3, paraconduit hernia repair achieved higher resolution than crural division (65.8% vs. 47.1%). The overall complication rate was 32.7%, with significantly higher major morbidity and mortality in C2 (20.0% and 3.6%) compared with C3 (13.4% and 1.7%) and C1 (16.7% and 2.8%, P = 0.047). Multivariable analysis identified no independent predictors of surgical success but was limited by heterogeneity and sample size. RESTORANT provides the first multicentric analysis of surgical DGCE repair. While symptom resolution is achievable across all classes, C2 interventions carry increased risks. These findings may help structure future prospective audits.