Clinical Focus


  • Hepatology
  • Liver Transplantation

Academic Appointments


Professional Education


  • Fellowship: Jackson Health System University of Miami (2025) FL
  • Residency: UCSF Fresno Internal Medicine Residency (2022) CA
  • Board Certification: American Board of Internal Medicine, Internal Medicine (2021)
  • Medical Education: St George's University School of Medicine Grenada West Indies (2018) NY West Indies

All Publications


  • Cirrhosis Conn's Current Therapy 2026 Sandhu, S., Martin, P. Elsevier. 2026: 211-224
  • Disparities in Utilization of Palliative Care in Acute-on-Chronic Liver Failure (ACLF) in the United States Sohal, A., Singh, C., Chikatmalla, R., Lin, J., Kohli, I., Sandhu, S., Najafian, N. LIPPINCOTT WILLIAMS & WILKINS. 2025: S519
  • Update on Organ Allocation and Liver Transplantation. Gastroenterology & hepatology Sandhu, S., Goldberg, D. 2025; 21 (7): 424-430

    Abstract

    Liver transplantation remains a lifesaving intervention for patients with end-stage liver disease; however, organ demand continues to far exceed the supply. The core ethical principles that guide scarce resource allocation include utility, equity, and prioritization of the sickest patients. Implementation of national organ allocation and distribution policy updates over the years have led to several positive changes, including earlier transplant of livers from sicker patients and decreased waitlist mortality rates. Current practices include utilization of the Model for End-Stage Liver Disease score to determine waitlist priority, with distribution protocols involving the use of the acuity circle model. Despite these improvements, geographic and socioeconomic disparities remain. This article reviews the history of liver allocation and distribution practices, the successes and challenges of current policies, and future frameworks aimed at providing equitable approaches to matching donors with candidates.

    View details for PubMedID 40893830

    View details for PubMedCentralID PMC12397788

  • Update on Organ Allocation and Liver Transplantation. Gastroenterology & hepatology Sandhu, S., Goldberg, D. 2025; 21 (7): 424-430

    Abstract

    Liver transplantation remains a lifesaving intervention for patients with end-stage liver disease; however, organ demand continues to far exceed the supply. The core ethical principles that guide scarce resource allocation include utility, equity, and prioritization of the sickest patients. Implementation of national organ allocation and distribution policy updates over the years have led to several positive changes, including earlier transplant of livers from sicker patients and decreased waitlist mortality rates. Current practices include utilization of the Model for End-Stage Liver Disease score to determine waitlist priority, with distribution protocols involving the use of the acuity circle model. Despite these improvements, geographic and socioeconomic disparities remain. This article reviews the history of liver allocation and distribution practices, the successes and challenges of current policies, and future frameworks aimed at providing equitable approaches to matching donors with candidates.

    View details for PubMedID 40893830

  • Hepatocellular Carcinoma in Cystic Fibrosis Liver Disease. Gastro hep advances Tarakji, R., Sandhu, S., Martin, E. F. 2025; 4 (10): 100727

    Abstract

    Cystic fibrosis, traditionally considered an infrequent childhood disease, has increased in incidence due to advances in screening, and therapies fortunately have advanced leading to increased survival rates. Cystic fibrosis liver disease (CFLD) is well-described in the pediatric population; however, with increased life expectancy rates, a second wave has been observed in adults and represents the third most common cause of death. Although complications of portal hypertension have been described in setting of CFLD, the development of hepatocellular carcinoma is an extremely rare event. We present a patient with CFLD who developed hepatocellular carcinoma that was successfully treated with microwave ablation.

    View details for DOI 10.1016/j.gastha.2025.100727

    View details for PubMedID 40917761

    View details for PubMedCentralID PMC12410007

  • Small Bowel Bleeding Due to Vascular Lesions: Pathogenesis and Management. Current gastroenterology reports Sandhu, S., Gross, J., Barkin, J. A. 2025; 27 (1): 37

    Abstract

    The purpose of this review is to provide a comprehensive review and recent updates in the understanding of the pathogenesis, diagnosis, and management of small bowel vascular lesions.Recent terminology has shifted from "obscure GI bleeding" to "small bowel bleeding", with the former reserved for cases when the source of bleeding is not detected despite a thorough evaluation of the entire GI tract, including the small bowel. Recent diagnostic advances including imaging, video capsule endoscopy (VCE), and deep enteroscopy have allowed for the identification of most small bowel bleeding sources. The incidence of small bowel bleeding remains a relatively uncommon event. Vascular lesions remain the most common etiology of small bowel bleeding, with angiodysplasia representing the majority of vascular small bowel lesions. Standard therapeutic approach includes adequate resuscitation and endoscopic evaluation, with consideration of medical therapy (including somatostatin analogues and antiangiogenic agents), endoscopic interventions, radiologic procedures, or surgical therapy in select patients.

    View details for DOI 10.1007/s11894-025-00989-1

    View details for PubMedID 40481967

    View details for PubMedCentralID PMC12145302

  • Expanding the Liver Donor Pool: Promise and Peril. Clinics in liver disease Goldberg, D., Sandhu, S. 2025; 29 (2): 235-252

    Abstract

    Liver transplantation remains a life-saving therapy for a growing list of indications. Although 10,660 adult liver transplants were performed in the United States in 2023, a 50% increase over the preceding decade, the demand continues to far exceed the supply. Efforts to expand the liver donor pool by using donors that were previously considered unsuitable have remained an important strategy to help overcome shortages. We discuss the progress that has been made over the past decade, as well as potential future barriers that will need to be overcome to help successfully expand the liver donor pool.

    View details for DOI 10.1016/j.cld.2024.12.004

    View details for PubMedID 40287269

  • Evaluating Risk Factors for Early-Onset Colorectal Cancer in a Large, Prospective Cohort. Digestive diseases and sciences Sandhu, S., Blandon, C., Kumar, S. 2025

    Abstract

    Despite the worrisome rise of early-onset colorectal cancer (EOCRC), risk factors have not been definitively established. We use a large, granular database to evaluate risk factors for EOCRC, investigate differences in associations with EOCRC and later-onset CRC (LOCRC), and compare metrics of accelerated aging, a hypothesized driver of EOCRC.This was a case-control analysis within the UK Biobank. Risk factors for each cancer were identified and compared, including aging measures (chronological age, telomere length, PhenoAge, and homeostatic dysregulation).A total of 31,164 persons were matched. We found an increased risk of EOCRC with PRS (OR 1.53; 95% CI 1.19-1.97; p < 0.001). LOCRC was associated with increasing PRS (OR 1.48; 95% CI 1.44 - 1.53; p < 0.001), increasing waist-to-hip ratio (OR 5.81; 95% CI 3.25 - 10.38; p < 0.001), family history of CRC (OR 1.27; 95% CI 1.16 - 1.40; p < 0.001), and history of smoking (OR 1.11; 95% CI 1.03 - 1.19; p = 0.01). Male sex and prior CRC screening were associated with reduced risk of LOCRC. The inclusion of PhenoAge as the measure of aging demonstrated the best model fit for both EOCRC and LOCRC. For each year that PhenoAge exceeded chronological age, the odds of EOCRC increased by 7%, while odds of LOCRC only increased by 1%.Within this study, we find that genetic risk variants are a significant driver of EOCRC risk. Accelerated aging appears to be associated with increased risk of both EOCRC and LOCRC, and measures such as PhenoAge warrant continued study.

    View details for DOI 10.1007/s10620-025-09055-2

    View details for PubMedID 40234296

  • Hepatocellular Carcinoma in Cirrhosis Due to Cystic Fibrosis Liver Disease Tarakji, R., Sandhu, S., Martin, P. LIPPINCOTT WILLIAMS & WILKINS. 2024: S2784-S2785
  • Portal Hypertension-Associated Gastric Polyp: A Source of Upper Gastrointestinal Bleeding in Cirrhosis Tarakji, R., Sandhu, S., Montgomery, E., Martin, P. LIPPINCOTT WILLIAMS & WILKINS. 2024: S2785
  • Pancreatic Metastasis From Papillary Thyroid Cancer as an Unusual Cause of Pancreatic Mass Lesion: A Case Report and Review of the Literature Sandhu, S., Poveda, J., Barkin, J. A. LIPPINCOTT WILLIAMS & WILKINS. 2024: S1873-S1874
  • ALPHA-1 ANTITRYPSIN PIMZ, PISS AND PISZ PHENOTYPES ARE ASSOCIATED WITH INCREASED LIVER RELATED DEATH IN ALCOHOL-ASSOCIATED AND NAFLD CIRRHOSIS Sandhu, S., Bastaich, D. R., Kaplan, D. E., Taddei, T. H., Dahman, B., John, B. V., VOCAL Grp Investigators LIPPINCOTT WILLIAMS & WILKINS. 2023: S1486-S1487
  • Spontaneous Bacterial Peritonitis: The Bug Matters. Digestive diseases and sciences Sandhu, S., John, B. V. 2023; 68 (5): 1667-1669

    View details for DOI 10.1007/s10620-023-07865-w

    View details for PubMedID 36929237

    View details for PubMedCentralID 7503635

  • CONCORDANCE OF ICD 9 AND 10 CODES AND CLINICAL DIAGNOSIS OF PRIMARY BILIARY CHOLANGITIS AND CIRRHOSIS John, B. V., Bastaich, D., Sandhu, S., Dahman, B. W B SAUNDERS CO-ELSEVIER INC. 2023: S617-S618
  • Long-term clinical outcomes of patients with COVID-19 and chronic liver disease: US multicenter COLD study. Hepatology communications Aby, E. S., Moafa, G., Latt, N., Sultan, M. T., Cacioppo, P. A., Kumar, S., Chung, R. T., Bloom, P. P., Gustafson, J., Daidone, M., Reinus, Z., Debes, J. D., Sandhu, S., Sohal, A., Khalid, S., Roytman, M., Catana, A. M., Wegermann, K., Carr, R. M., Saiman, Y., Kassab, I., Chen, V. L., Rabiee, A., Rosenberg, C., Nguyen, V., Gainey, C., Zhou, K., Chavin, K., Lizaola-Mayo, B. C., Chascsa, D. M., Varelas, L., Moghe, A., Dhanasekaran, R. 2023; 7 (1): e8874

    Abstract

    COVID-19 is associated with higher morbidity and mortality in patients with chronic liver diseases (CLDs). However, our understanding of the long-term outcomes of COVID-19 in patients with CLD is limited.We conducted a multicenter, observational cohort study of adult patients with CLD who were diagnosed with COVID-19 before May 30, 2020, to determine long-term clinical outcomes. We used a control group of patients with CLD confirmed negative for COVID-19.We followed 666 patients with CLD (median age 58 years, 52.8% male) for a median of 384 (interquartile range: 31-462) days. The long-term mortality was 8.1%; with 3.6% experiencing delayed COVID-19-related mortality. Compared to a propensity-matched control group of patients with CLD without COVID-19 (n=1332), patients with CLD with COVID-19 had worse long-term survival [p<0.001; hazards ratio (HR): 1.69; 95% CI: 1.19-2.41] and higher rate of hospitalization (p<0.001, HR: 2.00, 1.62-2.48) over a 1-year follow-up period. Overall, 29.9% of patients reported symptoms of long-COVID-19. On multivariable analysis, female sex (p=0.05, HR: 2.45, 1.01-2.11), Hispanic ethnicity (p=0.003, HR: 1.94, 1.26-2.99), and severe COVID-19 requiring mechanical ventilation (p=0.028, HR: 1.74, 1.06-2.86) predicted long-COVID-19. In survivors, liver-related laboratory parameters showed significant improvement after COVID-19 resolution. COVID-19 vaccine status was available for 72% (n=470) of patients with CLD and history of COVID-19, of whom, 70% (n=326) had received the COVID-19 vaccine.Our large, longitudinal, multicenter study demonstrates a high burden of long-term mortality and morbidity in patients with CLD and COVID-19. Symptoms consistent with long-COVID-19 were present in 30% of patients with CLD. These results illustrate the prolonged implications of COVID-19 both for recovering patients and for health care systems.

    View details for DOI 10.1097/01.HC9.0000897224.68874.de

    View details for PubMedID 36633476

  • COVID-19 AND NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD): A SINGLE CENTER EXPERIENCE DURING THE VACCINATION ERA Sandhu, S., Sohal, A., Petrosyan, A., Khalid, S., Rodriguez, E., Gill, A., Roytman, M. WILEY. 2022: S550-S551
  • Predictors of leaving against medical advice in patients with alcohol-related hepatitis. Annals of gastroenterology Sohal, A., Chaudhry, H., Bains, K., Dhaliwal, A., Sharma, R., Gupta, G., Singla, P., Dukovic, D., Sandhu, S., Roytman, M. 2022; 35 (5): 541-546

    Abstract

    Alcohol-related hepatitis is one of the most severe manifestations of alcohol-related liver disease and has been associated with significant morbidity, mortality and financial burden. Patients with alcohol use disorders are at risk of leaving against medical advice (LAMA); however, there is currently a lack of data in the literature to show which patients are at higher risk. In this study, we investigated the specific demographic factors and comorbidities associated with LAMA.Patients with a primary or secondary discharge diagnosis of alcohol-related hepatitis (ICD10-CM codes K70.4 and K70.1) between January 2016 and December 2019 were included in this study. Demographics, comorbidities, complications and interventions were studied in for patients who LAMA. Multivariate analysis was conducted to elucidate factors contributing to the increased risk of alcohol-related hepatitis.A total of 538,750 patients were admitted with a diagnosis of alcohol-related hepatitis. Of these, 31,500 (5.84%) patients LAMA. Older age, Hispanic race, private insurance, and higher income status were associated with a lower risk of LAMA, while younger age, African American race, lack of insurance and being in the lowest income quartile were associated with the highest risk.Our findings demonstrated that significant differences exist between patients with alcohol-related hepatitis who LAMA and those who remain hospitalized until discharge. We believe that this study will help healthcare providers identify patients at risk of LAMA, and help promote the targeted education of specific subgroups to improve their understanding of their disease state and decrease adverse events.

    View details for DOI 10.20524/aog.2022.0738

    View details for PubMedID 36061158

    View details for PubMedCentralID PMC9399570

  • Role of endoscopic evaluation prior to diagnostic transesophageal echocardiography: Is it necessary? JGH OPEN Sandhu, S., Alhankawi, D., Roytman, M., Jain, R., Prajapati, D. 2022; 6 (9): 595-598

    Abstract

    Esophagogastroduodenoscopy (EGD) is often performed prior to transesophageal echocardiogram (TEE) to evaluate for esophageal pathologies. Although TEE is a safe procedure, some contraindications exist, such as esophageal varices. The incidence of bleeding with TEE is <0.01%, which questions the need for this routine invasive procedure prior to TEE. We sought to characterize patients in whom pre-TEE endoscopy was requested to determine its clinical utility and identify those that would most benefit.We retrospectively studied patients who underwent EGD for TEE clearance between January 2014 and October 2019. We assessed how often EGD changed management and complications after TEE in those with EGD abnormalities.Eighty-three patients were included. Twenty-three percent had prior GI bleed, 63% had cirrhosis, 18% had known varices, and 7% had prior variceal bleed. The most common EGD findings were varices (33%). Eighty-one percent proceeded with TEE. Reasons for TEE deferral included varices (12.5%), high-risk bleeding lesion (12.5%), and mechanical abnormality (12.5%). In the majority (37.5%), TEE was deemed no longer indicated. No patient undergoing TEE had significant hemoglobin drop or overt bleeding. The most common reason for not performing TEE was unrelated to EGD findings: lack of ongoing indication for TEE.Based on our study, EGD is likely not needed for TEE clearance in patients with varices or prior GI bleed. Given that data are limited in patients with abnormalities such as strictures, EGD may still be warranted for these patients. Further studies to identify which patients will benefit from pre-TEE endoscopy are warranted.

    View details for DOI 10.1002/jgh3.12792

    View details for Web of Science ID 000827313000001

    View details for PubMedID 36091317

    View details for PubMedCentralID PMC9446391

  • Salmonella typhimurium as a Rare Cause of Small Bowel Obstruction. Journal of community hospital internal medicine perspectives Sandhu, S., Alhankawi, D., Prajapati, D. 2022; 12 (4): 111-113

    Abstract

    Small bowel obstruction (SBO) is an extremely common condition for hospitalization throughout the world. Although most causes of are due to post-operative adhesions, there are much less common causes which remain important to consider as differentials due to diagnostic and treatment implications. To the best of our knowledge, we are presenting the first case of SBO caused by Salmonella typhimurium induced terminal ileitis. We discuss how certain characteristics on CT imaging along with culture data led to our diagnosis and successful treatment.

    View details for DOI 10.55729/2000-9666.1084

    View details for PubMedID 36262905

    View details for PubMedCentralID PMC9533796

  • Orbital Myositis in a Patient With Ileal Crohn's Disease in Remission on Vedolizumab. ACG case reports journal Sandhu, S., Wang, T., Donet, J. A. 2022; 9 (5): e00775

    Abstract

    Orbital myositis (OM) is an extremely rare ocular extraintestinal manifestation of inflammatory bowel disease. Acute or chronic inflammation of one or more extraocular muscles leads to symptoms related to the mass effect including orbital pain, swelling, ophthalmoplegia, proptosis, and diplopia. Although the use of steroids typically leads to rapid resolution of symptoms, recurrence is common, necessitating long-term steroid-sparing therapies. Given the rare presentation of OM, its pathogenesis and optimal therapy are not well established. We present a young woman with Crohn's disease in remission on vedolizumab who developed OM, and we discuss our management approach.

    View details for DOI 10.14309/crj.0000000000000775

    View details for PubMedID 35919668

    View details for PubMedCentralID PMC9287271

  • Seasonal Variations of Hospital Admissions for Alcohol-Related Hepatitis in the United States. Gastroenterology research Sohal, A., Bains, K., Dhaliwal, A., Chaudhry, H., Sharma, R., Singla, P., Gupta, G., Dukovic, D., Sandhu, S., Roytman, M., Tringali, S. 2022; 15 (2): 75-81

    Abstract

    Clinical experience suggests an increased hospitalization rate for alcohol-related hepatitis (AH) in the winter months; however, seasonal variations in the prevalence of hospitalizations for AH have not been described previously. We hypothesized that AH hospitalizations would be higher in the winter months due to the holiday season and increased alcohol sales.Patients with primary or secondary discharge diagnosis of AH were included in the study (International Classification of Diseases, Clinical Modification-10th Revision codes K70.4 and K70.1) between January 2016 and December 2019. The primary outcome measure for this study was daily hospitalizations by each month of the year. Secondary outcome measures included the rate of in-hospital mortality associated with AH, for each month.The highest number of AH-related admissions was reported in July (n = 56,800; 9%), followed by August (n = 55,700; 8.8%) and May (n = 54,865; 8.7%). February had the lowest number of admissions (n = 46,550; 7.37%). The adjusted mortality was highest in December (overall mortality: 9.6%; adjusted odds ratio: 1.29; 95% confidence interval: 1.142 - 1.461; P < 0.0001) and lowest in May (overall mortality rate: 7.7%). No difference was noted between length of stay and total hospitalization cost between months.Our findings demonstrate that seasonal variations in hospitalizations related to AH do exist across the United States. Regional differences also exist and follow unique patterns. The increase in admissions for AH is in line with other studies suggesting that heavy drinking happens during the warm season. Hospital administrators and other stewards of healthcare resources can use seasonal patterns to guide allocation of resources.

    View details for DOI 10.14740/gr1506

    View details for PubMedID 35572478

    View details for PubMedCentralID PMC9076155

  • Marked Hyperbilirubinemia Associated with Primary Myelofibrosis Responsive to Ruxolitinib. Case reports in hepatology Sandhu, S., Chaudhry, H., Zhang, S., Prajapati, D. 2022; 2022: 9630996

    Abstract

    Primary myelofibrosis (PMF) is a chronic myeloproliferative disorder seen in older adults which can present both with hepatosplenomegaly as well as mild nonspecific liver enzyme abnormalities. Mild elevations in bilirubin can occasionally be seen due to both intravascular hemolysis as well as extramedullary hematopoiesis. Marked hyperbilirubinemia as a presenting sign of PMF progression, however, has not been reported. We present the case of a patient with a remote diagnosis of PMF, who presented with marked hyperbilirubinemia with a notable response to ruxolitinib.

    View details for DOI 10.1155/2022/9630996

    View details for PubMedID 35669160

  • Turmeric-Induced Hepatotoxicity: Report of 2 Cases. International medical case reports journal Sohal, A., Alhankawi, D., Sandhu, S., Chintanaboina, J. 2021; 14: 849-852

    Abstract

    The use of herbal and dietary supplements is rising in the United States. Turmeric has been one of the most popular supplements recently, used widely for various conditions such as arthritis, digestive disorder, and liver conditions. Although rarely reported, hepatotoxicity can happen with turmeric use. Here, we present 2 cases of drug-induced liver injury due to turmeric use with the complete resolution after cessation.

    View details for DOI 10.2147/IMCRJ.S333342

    View details for PubMedID 34992472

    View details for PubMedCentralID PMC8711139

  • A Rare Case of Rectal Squamous Cell Carcinoma Treated With Nigro Protocol Chaudhry, H., Sandhu, S., Zhang, S., Prajapati, D. N. LIPPINCOTT WILLIAMS & WILKINS. 2021: S773
  • Comparison of Non-Invasive Liver Fibrosis Scores in Predicting Outcomes Among Non-Alcoholic Fatty Liver Disease (NAFLD) Patients with COVID-19 Sandhu, S., Alhankawi, D., Sohal, A., Khalid, S., Roytman, M. LIPPINCOTT WILLIAMS & WILKINS. 2021: S537
  • LONG-TERM CLINICAL OUTCOMES OF PATIENTS WITH COVID-19 AND CHRONIC LIVER DISEASE: US MULTICENTER STUDY COLD STUDY Aby, E., Gustafson, J. L., Daidone, M., Chung, R. T., Sandhu, S., Sohal, A., Khalid, S., Roytman, M., Varelas, L., Moghe, A., Moafa, G., Latt, N. L., Carr, R. M., Saiman, Y., Catana, A. M., Kassab, I., Chen, V., Rosenberg, C., Debes, J. D., Rabiee, A., Nguyen, V., Gainey, C., Zhou, K., Chavin, K. D., Lizaola-Mayo, B., Kumar, S., Dhanasekaran, R. WILEY. 2021: 48A-49A
  • Marked Hyperbilirubinemia Associated With Primary Myelofibrosis Responsive to Ruxolitinib Chaudhry, H., Sandhu, S., Tasso, D. M., Prajapati, D. N. LIPPINCOTT WILLIAMS & WILKINS. 2021: S1195
  • Identifying areas of improvement in nursing knowledge regarding hepatic encephalopathy management. Journal of community hospital internal medicine perspectives Sohal, A., Green, V., Sandhu, S., Roytman, M. 2021; 11 (5): 722-726

    Abstract

    Hepatic encephalopathy (HE) is a reversible brain dysfunction caused by liver insufficiency and portosystemic shunting. Hepatic encephalopathy is a common complication of advanced liver disease and is on a rise with the increasing incidence of non-alcoholic steatohepatitis (NASH). Since partnership with nursing staff is a critical part of successful management of these complex patients, we conducted a survey assessing their knowledge regarding HE.169 nurses participated in the survey. We found that more than 30% of the nurses did not know that ammonia is one of the toxins responsible for causing hepatic encephalopathy. We also found that 20% of the nurses had difficulty answering questions regarding titration of lactulose to bowel movements. Dietary education is a significant area for improvement as 80% of the nurses wanted to restrict fat and carbohydrate intake in these patients. With this simple survey, we identified important knowledge gaps among experienced nurses at our institution. We believe that by improving knowledge through focused lectures, we can improve patient care and reduce the length of hospitalizations in patients with HE.

    View details for DOI 10.1080/20009666.2021.1954784

    View details for PubMedID 34567473

    View details for PubMedCentralID PMC8462881

  • Emphysematous Pancreatitis Mimicking Bowel Perforation. ACG case reports journal Sandhu, S., Alhankawi, D., Chintanaboina, J., Prajapati, D. 2021; 8 (7): e00641

    Abstract

    Emphysematous pancreatitis is a rare complication of acute necrotizing pancreatitis, which carries a mortality rate of up to 70%. It has only been described in isolated case reports. We report a patient who presented with suspected bowel perforation and was subsequently found to have emphysematous pancreatitis that was managed successfully with multidisciplinary team involvement.

    View details for DOI 10.14309/crj.0000000000000641

    View details for PubMedID 34307719

    View details for PubMedCentralID PMC8294876

  • PREDICTORS OF OUTCOMES OF COVID-19 INFECTION IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) Sandhu, S., Sohal, A., Khalid, S., Alhankawi, D., Jain, R., Roytman, M. W B SAUNDERS CO-ELSEVIER INC. 2021: S757
  • Acute esophageal necrosis complicated by refractory stricture formation JGH OPEN Sandhu, S., Wang, T., Prajapati, D. 2021; 5 (4): 528-530

    Abstract

    Acute esophageal necrosis (AEN) is a rare presentation of severe esophageal injury. The optimal long-term management of complications related to AEN, particularly stricture formation, are not well defined. We report a case of AEN in a patient who presented with diabetic ketoacidosis (DKA) and had dysphagia due to refractory stricture formation after mucosal healing occurred. A 62-year-old male with diabetes mellitus presented with altered mental status. He was admitted for hypovolemic shock secondary to DKA and treated with vasopressors, fluid resuscitation, and insulin. After resolution of DKA, he reported persistent dysphagia. Upper endoscopy showed circumferential black mucosal discoloration throughout the entire esophagus that spared the gastroesophageal junction. He was diagnosed with AEN and was continued on a proton pump inhibitor and sucralfate with improvement in symptoms. Repeat endoscopy 4 weeks later showed a 10-cm benign-appearing stricture in the mid esophagus. He underwent dilation with temporary symptomatic relief; however, recurrence in symptoms has thus far necessitated a total of 10 repeat upper endoscopies, including repeat dilations along with local steroid injection therapy. AEN is a rare presentation of severe esophageal injury and is typically associated with severe hemodynamic compromise. Although most cases resolve with supportive care and mucosal healing, there is little information regarding prognosis and optimal management of complications, such as refractory esophageal strictures. We describe a case of AEN complicated by refractory symptomatic esophageal stricture despite several dilations and intralesional steroid injections and discuss our approach to treatment.

    View details for DOI 10.1002/jgh3.12520

    View details for Web of Science ID 000623513900001

    View details for PubMedID 33869789

    View details for PubMedCentralID PMC8035479

  • P031 Ozanimod in Patients with Moderate-to-Severe Ulcerative Colitis: Long-Term Safety and Efficacy from the Phase 2 TOUCHSTONE Study 4-Year Open-Label Extension. The American journal of gastroenterology William, S., Brian, F., Stephen, H., Séverine, V., Subrata, G., Wenzhong, L., AnnKatrin, P., Lorna, C., Vivian, H., Keith, U., Doug, W., Geert, D. 2020; 115 (Suppl 1): S8
  • "Black Esophagus": A Rare Complication of Diabetic Ketoacidosis Sandhu, S., Wang, T., Prajapati, D. LIPPINCOTT WILLIAMS & WILKINS. 2020: S1069-S1070
  • Emphysematous Pancreatitis Mimicking Bowel Perforation Sandhu, S., Alhankawi, D., Chintanaboina, J., Prajapati, D. LIPPINCOTT WILLIAMS & WILKINS. 2020: S762
  • Qualitative Analysis of Mobile Health Applications for Celiac Disease Patients Sandhu, S., Gill, A., Alhankawi, D., Sohal, A., Roytman, M., Theethira, T. LIPPINCOTT WILLIAMS & WILKINS. 2020: S658
  • A Rare Consult for Liver Injury: Hemophagocytic Lymphohistiocytosis Sandhu, S., Alhankawi, D., Taguibao, R., Roytman, M. LIPPINCOTT WILLIAMS & WILKINS. 2020: S1432-S1433
  • <i>Salmonella typhi</i> Gastroenteritis as a Rare Cause of Small Bowel Obstruction Sandhu, S., Alhankawi, D., Prajapati, D. LIPPINCOTT WILLIAMS & WILKINS. 2019: S1442