{"id":"https://openalex.org/W4403725742","doi":"https://doi.org/10.14309/01.ajg.0001043360.27432.54","title":"S3498 Lactulose-Induced Bowel Perforation","display_name":"S3498 Lactulose-Induced Bowel Perforation","publication_year":2024,"publication_date":"2024-10-01","ids":{"openalex":"https://openalex.org/W4403725742","doi":"https://doi.org/10.14309/01.ajg.0001043360.27432.54"},"language":"en","primary_location":{"id":"doi:10.14309/01.ajg.0001043360.27432.54","doi":"https://doi.org/10.14309/01.ajg.0001043360.27432.54","is_oa":false,"landing_page_url":"https://doi.org/10.14309/01.ajg.0001043360.27432.54","pdf_url":null,"source":{"id":"https://openalex.org/S66441642","display_name":"The American Journal of Gastroenterology","issn_l":"0002-9270","issn":["0002-9270","1572-0241"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Gastroenterology","raw_type":"journal-article"},"volume":null,"type":"conference-abstract","is_traditional":false,"indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5062443551","display_name":"Anandita Kishore","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210125451","display_name":"Sisters of Charity Hospital","ror":"https://ror.org/02xxgh713","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210125451"]},{"id":"https://openalex.org/I63190737","display_name":"University at Buffalo, State University of New York","ror":"https://ror.org/01y64my43","country_code":"US","type":"education","lineage":["https://openalex.org/I63190737"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Anandita Kishore","raw_affiliation_strings":["Sisters of Charity Hospital, University of Buffalo, Buffalo, NY;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Sisters of Charity Hospital, University of Buffalo, Buffalo, NY;","institution_ids":["https://openalex.org/I4210125451","https://openalex.org/I63190737"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5056268394","display_name":"Peter Lymberopoulos","orcid":"https://orcid.org/0000-0002-4657-1349","observed_orcids":["https://orcid.org/0000-0002-4657-1349"]},"institutions":[{"id":"https://openalex.org/I181697535","display_name":"SUNY Downstate Health Sciences University","ror":"https://ror.org/0041qmd21","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I181697535"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Peter Lymberopoulos","raw_affiliation_strings":["State University of New York Downstate Medical Center, Brooklyn, NY"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"State University of New York Downstate Medical Center, Brooklyn, NY","institution_ids":["https://openalex.org/I181697535"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5104253231","display_name":"Dinesh Nirmal","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I181697535","display_name":"SUNY Downstate Health Sciences University","ror":"https://ror.org/0041qmd21","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I181697535"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Dinesh Nirmal","raw_affiliation_strings":["State University of New York Downstate Medical Center, Brooklyn, NY"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"State University of New York Downstate Medical Center, Brooklyn, NY","institution_ids":["https://openalex.org/I181697535"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5067962103","display_name":"Udit Dey","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I181697535","display_name":"SUNY Downstate Health Sciences University","ror":"https://ror.org/0041qmd21","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I181697535"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Udit Dey","raw_affiliation_strings":["State University of New York Downstate Medical Center, Brooklyn, NY"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"State University of New York Downstate Medical Center, Brooklyn, NY","institution_ids":["https://openalex.org/I181697535"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5113295483","display_name":"Shruthi Sivakumar","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I181697535","display_name":"SUNY Downstate Health Sciences University","ror":"https://ror.org/0041qmd21","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I181697535"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Shruthi Sivakumar","raw_affiliation_strings":["State University of New York Downstate Medical Center, Brooklyn, NY"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"State University of New York Downstate Medical Center, Brooklyn, NY","institution_ids":["https://openalex.org/I181697535"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5074278070","display_name":"Asher Gorantla","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I181697535","display_name":"SUNY Downstate Health Sciences University","ror":"https://ror.org/0041qmd21","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I181697535"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Asher Gorantla","raw_affiliation_strings":["State University of New York Downstate Medical Center, Brooklyn, NY"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"State University of New York Downstate Medical Center, Brooklyn, NY","institution_ids":["https://openalex.org/I181697535"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5090303751","display_name":"Suzette Graham-Hill","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I181697535","display_name":"SUNY Downstate Health Sciences University","ror":"https://ror.org/0041qmd21","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I181697535"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Suzette Graham-Hill","raw_affiliation_strings":["State University of New York Downstate Medical Center, Brooklyn, NY"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"State University of New York Downstate Medical Center, Brooklyn, NY","institution_ids":["https://openalex.org/I181697535"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5062443551"],"corresponding_institution_ids":["https://openalex.org/I4210125451","https://openalex.org/I63190737"],"apc_list":{"value":4390,"currency":"USD","value_usd":4390},"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":1,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":"119","issue":"10S","first_page":"S2323","last_page":"S2323"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10337","display_name":"Liver Disease and Transplantation","score":0.47360000014305115,"subfield":{"id":"https://openalex.org/subfields/2721","display_name":"Hepatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10337","display_name":"Liver Disease and Transplantation","score":0.47360000014305115,"subfield":{"id":"https://openalex.org/subfields/2721","display_name":"Hepatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10365","display_name":"Gastrointestinal motility and disorders","score":0.09319999814033508,"subfield":{"id":"https://openalex.org/subfields/2715","display_name":"Gastroenterology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11378","display_name":"Gastrointestinal Bleeding Diagnosis and Treatment","score":0.044599998742341995,"subfield":{"id":"https://openalex.org/subfields/2715","display_name":"Gastroenterology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/lactulose","display_name":"lactulose","score":0.9959999918937683},{"id":"https://openalex.org/keywords/intestinal-perforation","display_name":"intestinal perforation","score":0.9810000061988831},{"id":"https://openalex.org/keywords/hepatic-encephalopathy","display_name":"hepatic encephalopathy","score":0.9959999918937683},{"id":"https://openalex.org/keywords/pneumoperitoneum","display_name":"pneumoperitoneum","score":0.8619999885559082},{"id":"https://openalex.org/keywords/adverse-drug-reactions","display_name":"adverse drug reactions","score":0.6169999837875366},{"id":"https://openalex.org/keywords/emergency-exploratory-laparotomy","display_name":"emergency exploratory laparotomy","score":0.8489999771118164},{"id":"https://openalex.org/keywords/hemicolectomy","display_name":"hemicolectomy","score":0.8629999756813049},{"id":"https://openalex.org/keywords/transverse-colectomy","display_name":"transverse colectomy","score":0.8320000171661377}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9707974195480347},{"id":"https://openalex.org/C2777448540","wikidata":"https://www.wikidata.org/wiki/Q422689","display_name":"Lactulose","level":2,"score":0.8953031301498413},{"id":"https://openalex.org/C3018436397","wikidata":"https://www.wikidata.org/wiki/Q279324","display_name":"Bowel perforation","level":3,"score":0.6972108483314514},{"id":"https://openalex.org/C2778456384","wikidata":"https://www.wikidata.org/wiki/Q1508510","display_name":"Perforation","level":3,"score":0.6012165546417236},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.38230448961257935},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.34721606969833374},{"id":"https://openalex.org/C81182388","wikidata":"https://www.wikidata.org/wiki/Q353963","display_name":"Complication","level":2,"score":0.16178050637245178},{"id":"https://openalex.org/C2778527123","wikidata":"https://www.wikidata.org/wiki/Q11750728","display_name":"Punching","level":2,"score":0.0},{"id":"https://openalex.org/C191897082","wikidata":"https://www.wikidata.org/wiki/Q11467","display_name":"Metallurgy","level":1,"score":0.0},{"id":"https://openalex.org/C192562407","wikidata":"https://www.wikidata.org/wiki/Q228736","display_name":"Materials science","level":0,"score":0.0}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.14309/01.ajg.0001043360.27432.54","doi":"https://doi.org/10.14309/01.ajg.0001043360.27432.54","is_oa":false,"landing_page_url":"https://doi.org/10.14309/01.ajg.0001043360.27432.54","pdf_url":null,"source":{"id":"https://openalex.org/S66441642","display_name":"The American Journal of Gastroenterology","issn_l":"0002-9270","issn":["0002-9270","1572-0241"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Gastroenterology","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W1564351940","https://openalex.org/W4406875630","https://openalex.org/W3088300553","https://openalex.org/W4399079848","https://openalex.org/W2141579284","https://openalex.org/W2424381479","https://openalex.org/W4387733237","https://openalex.org/W983253772","https://openalex.org/W6979002868","https://openalex.org/W2410098526"],"abstract_inverted_index":{"Introduction:":[0],"Hepatic":[1],"encephalopathy":[2],"(HE)":[3],"is":[4,11,198,210,235,243],"a":[5,109,236],"commonly":[6],"encountered":[7],"clinical":[8],"entity":[9],"and":[10,158,171,220],"effectively":[12],"treated":[13,42,67],"with":[14,39,43,56,68,136],"lactulose,":[15],"although":[16],"rare,":[17],"when":[18,229],"higher":[19,230],"doses":[20,123,231,285],"of":[21,60,102,124,127,164,206,217,262,286,289],"lactulose":[22,44,110,128,263,273,290],"are":[23,224,232],"required":[24],"to":[25,98,113,140,149,160,177,253,272],"induce":[26],"stools,":[27],"it":[28],"can":[29],"result":[30],"in":[31,203,257],"fatal":[32],"bowel":[33,46,117,166,218,240,255],"perforation.":[34],"We":[35],"describe":[36],"1":[37],"patient":[38,134,193],"HE":[40],"being":[41],"developing":[45],"perforation":[47,241,256],"requiring":[48,168],"emergent":[49],"exploratory":[50,156],"laparotomy.":[51],"Case":[52],"Description/Methods:":[53],"75-year-old":[54],"man":[55],"past":[57],"medical":[58],"history":[59],"atrial":[61],"fibrillation":[62],"on":[63,73,108,214],"anticoagulation,":[64],"prostate":[65],"cancer":[66],"radiation,":[69],"human":[70],"immunodeficiency":[71],"virus":[72],"highly":[74],"active":[75],"antiretroviral":[76],"therapy":[77],"(CD4":[78],"count":[79],"greater":[80],"than":[81],"200),":[82],"diabetes":[83],"mellitus,":[84],"hypertension,":[85],"congestive":[86],"heart":[87],"failure,":[88],"alcohol":[89],"liver":[90],"disease":[91],"admitted":[92],"for":[93,153,239],"altered":[94],"mental":[95],"status.":[96],"Due":[97],"the":[99,150,178,189,192,199,204,215,221,251,258,267,276],"high":[100],"likelihood":[101],"hepatic":[103,207],"encephalopathy,":[104],"he":[105],"was":[106,146,175],"started":[107],"regimen":[111],"titrated":[112,212],"achieve":[114],"2":[115,122,284],"soft":[116],"movements":[118,219],"per":[119],"day.":[120],"After":[121],"30":[125,287],"grams":[126],"were":[129],"administered":[130],"3":[131,281],"hours":[132,282],"apart,":[133],"decompensated":[135],"acute":[137],"abdomen,":[138],"found":[139,159],"have":[141,161],"pneumoperitoneum":[142],"(Figure":[143],"1).":[144],"He":[145,174],"immediately":[147],"taken":[148],"operating":[151],"room":[152],"an":[154],"emergency":[155],"laparotomy":[157],"multiple":[162],"foci":[163],"large":[165],"perforations":[167],"right":[169],"hemicolectomy":[170],"transverse":[172],"colectomy.":[173],"transferred":[176],"surgical":[179],"intensive":[180],"care":[181],"unit":[182],"where,":[183],"despite":[184],"aggressive":[185],"resuscitative":[186],"measures":[187],"over":[188],"following":[190],"days,":[191],"passed":[194],"away.":[195],"Discussion:":[196],"Lactulose":[197],"first":[200],"line":[201],"approach":[202],"treatment":[205],"encephalopathy.":[208],"Dosing":[209],"usually":[211,225],"based":[213],"number":[216],"side":[222,259],"effects":[223],"minimal":[226],"but":[227],"rarely":[228],"required,":[233],"there":[234],"potential":[237],"risk":[238],"which":[242],"fatal.":[244],"Through":[245],"this":[246],"case":[247],"report,":[248],"we":[249],"emphasize":[250],"need":[252],"include":[254],"effect":[260],"profile":[261],"therapy.Figure":[264],"1.:":[265],"On":[266,275],"left,":[268],"chest":[269,278],"x-ray":[270,279],"prior":[271],"administration.":[274],"right,":[277],"performed":[280],"after":[283],"gm":[288],"showing":[291],"pneumoperitoneum.":[292]},"counts_by_year":[{"year":2025,"cited_by_count":1}],"updated_date":"2026-10-13T10:08:12.033832","created_date":"2024-10-25T00:00:00"}
