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Case Reports in Gastroenterology

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https://www.readbyqxmd.com/read/28690492/interval-squamous-cell-carcinoma-of-the-rectum
#1
Daryl Ramai, Kinesh Changela, Jonathan Lai, Ghulamullah Shahzad, Madhavi Reddy
Squamous cell carcinoma (SCC) of the rectum is a rare clinical entity with an incidence rate of 0.1-0.25% per 1,000 cases. Though its etiology and pathogenesis remains unclear, it has been associated with chronic inflammation and infections. Herein, we report a case of an 82-year-old female who presented with a 2-month history of worsening abdominal pain, hematochezia, and bilateral inguinal lymphadenopathy with right-sided purulent discharge. Two years prior, she had had an unremarkable screening colonoscopy which met all quality indicators...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28690491/a-complicated-thread-abdominal-actinomycosis-in-a-young-woman-with-crohn-disease
#2
Ari Nahum, Gregory Filice, Ashish Malhotra
Crohn disease is a chronic inflammatory condition that primarily affects the gastrointestinal tract. Typical manifestations include fever, weight loss, fatigue, and abdominal pain, and abdominal abscesses and fistulae are frequent complications. Abdominal actinomycosis is a subacute or indolent disease associated with Actinomyces spp. Symptoms can be very similar to those of Crohn disease, and fistulae are also common. Since ulcerations in the intestinal tract are thought to be caused by Actinomyces escaping from the gut lumen and establishing intra-abdominal infection, it seems likely that abdominal actinomycosis may occur in patients with inflammatory bowel disease...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28690490/a-hepatitis-c-virus-associated-cirrhotic-patient-developing-interstitial-pneumonia-during-the-course-of-antiviral-therapy-with-ombitasvir-paritaprevir-ritonavir
#3
Kazuo Tarao, Kouzo Yamada
Oral direct-acting antivirals (DAAs) are the main therapy for hepatitis C virus (HCV)-associated liver disease in Japan. Daclatasvir/asunaprevir is the first agent and sofosbuvir/ledipasvir is the secondary agent for HCV genotype 1b. More recently, ombitasvir/paritaprevir/ritonavir is also recommended as a potent therapy for HCV genotype 1b. Among the adverse events associated with these oral DAAs, interstitial pneumonia is one of the most severe ones. Regarding treatment with daclatasvir plus asunaprevir or sofosbuvir plus ledipasvir, a few cases have already been reported in a postmarketing surveillance...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626385/urinary-tract-infection-associated-with-a-celiac-crisis-a-preceding-or-precipitating-event
#4
Abhinav Tiwari, Khola Qamar, Himani Sharma, Sameh Bashar Almadani
Celiac crisis is a rare life-threatening presentation of celiac disease that manifests as profuse diarrhea, hypoproteinemia, and severe metabolic disturbances. It may be precipitated by a general immune stimulus such as surgery, infection, or pregnancy. We report the case of a 26-year-old woman who presented with a celiac crisis, potentially triggered by a preceding urinary tract infection. Metabolic derangement is caused by malabsorption and profuse diarrhea, which can be unremitting unless the celiac crisis is recognized, and treatment with gluten restriction is initiated...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626384/acute-pancreatitis-an-atypical-presentation
#5
Omar Nadhem, Omar Salh
Acute pancreatitis is an important cause of acute upper abdominal pain. Because its clinical features are similar to a number of other acute illnesses, it is difficult to make a diagnosis only on the basis of symptoms and signs. The diagnosis of acute pancreatitis is based on 2 of the following 3 criteria: (1) abdominal pain consistent with pancreatitis, (2) serum lipase and/or amylase ≥3 times the upper limit of normal, and (3) characteristic findings from abdominal imaging. The sensitivity and specificity of lipase in diagnosing acute pancreatitis are undisputed...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626383/an-alternative-approach-to-the-terminal-management-of-ogilvie-syndrome
#6
Daniel Galban, Joshua J Baiel
Ogilvie syndrome is defined as colonic pseudo-obstruction due to nonmechanical causes. Mortality of nearly 50% is associated with perforation of the distended, pseudo-obstructed colon. While conservative medical therapy has proven to be beneficial in a majority of cases, >3% of patients have significant distention or perforation of the colon that warrants surgical resection. The case of a 48-year-old male with progressive abdominal discomfort and distention 12 days following knee replacement surgery is presented...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626382/a-symptomatic-coffee-bean-acute-sigmoid-volvulus
#7
Michael Scharl, Luc Biedermann
An acute sigmoid volvulus is due to the torsion of the sigmoid colon around its mesenteric axis. It mainly occurs in elderly patients and represents an abdominal emergency requiring urgent treatment. A 53-year-old male patient with severe craniocerebral injury and traumatic subarachnoidal bleeding 3 weeks prior presented on the ward with distended abdomen without abdominal pain, muscular defense, or resistances. He featured large volume diarrhea within the last few hours without signs of bleeding. A plain abdominal X-ray demonstrated a coffee bean sign indicating a sigmoid volvulus...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626381/nilotinib-induced-acute-pancreatitis-in-a-patient-with-chronic-myeloid-leukemia
#8
Vihang Patel, Anil Pattisapu, Karim Attia, John Weiss
Nilotinib, a second-generation tyrosine kinase inhibitor, is used for treatment of chronic myeloid leukemia (CML); it has been widely used especially for imatinib-resistant CML. Despite being a novel drug in this therapeutic class, it has the potential to be harmful. We present the case of an elderly woman who developed life-threatening acute pancreatitis as an adverse event after having started the drug. There is only one reported case in the literature of nilotinib-induced acute pancreatitis. The purpose of this case report is to educate physicians who prescribe this medication to be aware of potential life-threatening adverse events...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626380/clinical-and-pathologic-remission-of-pediatric-ulcerative-colitis-with-serum-derived-bovine-immunoglobulin-added-to-the-standard-treatment-regimen
#9
Rachelle A Soriano, Asuncion G Ramos-Soriano
Ulcerative colitis (UC) is a chronic inflammatory bowel disease that is particularly troublesome for pediatric patients, as current therapeutic options consist of biologic agents and steroids which alter the immune response and have the harmful side effect of leaving the patient more susceptible to opportunistic infections and eventual surgery. Another option for therapy exists in the form of serum-derived bovine immunoglobulin/protein isolate (SBI), the key ingredient in a medical food, EnteraGam®. The FDA has reviewed the safety of SBI and issued a no challenge letter to the generally recognized as safe (GRAS) findings for this medical food...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626379/fifteen-year-old-male-with-type-2-autoimmune-pancreatitis-an-argument-for-endoscopy
#10
Nathan T Kolasinski, Marc T Johannsen, Justin R Hollon
Type 2 autoimmune pancreatitis, an increasingly recognized etiology of pancreatitis in patients less than 20 years old, has characteristically been diagnosed with the histological finding of duct-centric pancreatitis in a patient who lacks elevated serum immunoglobulin G4. We present the case of a nonobese 15-year-old male, without any chronic medical conditions, who presented with the chief complaint of abdominal pain. The laboratory study results were remarkable for a lipase level of 5,419 U/L and a γ-glutamyl transferase level of 373 U/L...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626378/partial-hepatectomy-with-middle-hepatic-vein-reconstruction-using-a-left-inferior-vena-cava-graft
#11
Yusuke Kawamoto, Yusuke Ome, Kazuyuki Kawamoto
Duplicated inferior vena cava (IVC) is a rare congenital anomaly. We describe the utility of a new graft from the left IVC in a patient with duplicated IVC for reconstructing the middle hepatic vein (MHV) after partial hepatectomy with MHV resection. A 67-year-old woman with hepatitis C was found to have a liver tumor. Magnetic resonance imaging confirmed that the tumor, which was attached to the MHV, was hepatocellular carcinoma. Central bisectionectomy (S4, S5, and S8 resection) could not be tolerated because of poor liver function and a low future liver remnant volume...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626377/kidney-injury-due-to-ureteral-obstruction-caused-by-compression-from-infected-simple-hepatic-cyst
#12
Naoya Sawada, Tetsu Endo, Kenichiro Mikami, Go Igarashi, Juichi Sakamoto, Hiroshi Tono, Shinsaku Fukuda
Simple hepatic cysts are common and most often asymptomatic. In symptomatic cases, hemorrhage, rupture, and infection are major complications. However, urinary tract obstruction caused by a simple hepatic cyst is rare. We treated an 82-year-old Japanese man with an infected giant hepatic cyst causing right hydronephrosis who had a past history of left nephrectomy for renal cell carcinoma. The patient underwent ultrasound-guided percutaneous drainage and sclerotherapy with minocycline hydrochloride for the infected hepatic cyst...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626376/successful-treatment-for-chronic-hepatitis-c-autoimmune-hepatitis-overlap-syndrome-due-to-daclatasvir-and-asunaprevir
#13
Ayumi Sugiura, Shuichi Wada, Hiromitsu Mori, Takefumi Kimura, Yoshiaki Matsuda, Naoki Tanaka, Eiji Tanaka, Kendo Kiyosawa
Persistent hepatitis C virus (HCV) infection may induce autoimmune diseases and chronic hepatitis C is sometimes accompanied by autoimmune hepatitis (AIH). However, we are worried about the treatment for chronic hepatitis C-AIH overlap syndrome because interferon-based antiviral therapies may enhance autoimmunity and immunosuppressive corticosteroid administration may promote viral replication. Here, we report a patient having chronic hepatitis C-AIH overlap syndrome treated with the direct-acting antivirals (DAA), daclatasvir and asunaprevir...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626375/intravenous-bevacizumab-therapy-in-a-patient-with-hereditary-hemorrhagic-telangiectasia-eng-e137k-alcoholic-cirrhosis-and-portal-hypertension
#14
Luigi F Bertoli, Pauline L Lee, Lauren Lallone, James C Barton
Intravenous bevacizumab decreased mucosal bleeding in some patients with hereditary hemorrhagic telangiectasia (HHT). We treated a 47-year-old male who had HHT, severe epistaxis, and gastrointestinal bleeding, alcoholic cirrhosis, and portal hypertension with intravenous bevacizumab 2.5 mg/kg every 2 weeks. We tabulated these measures weekly during weeks 1-33 (no bevacizumab); 34-57 (bevacizumab); and 58-97 (no bevacizumab): hemoglobin (Hb) levels; platelet counts; units of transfused packed erythrocytes (PRBC units); and quantities of iron infused as iron dextran to support erythropoiesis...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626374/bochdalek-hernia-in-an-adult-with-upper-gastrointestinal-bleeding
#15
Mohammed Al-Dugdugi, Abdulhameed Alhazmi, Abdulhadi Khaliel, Luis Perez
Bochdalek hernia (BH) can be a life-threatening condition in infants. Approximately 85.3% of newborns with a BH are immediately at high risk and have a high mortality rate due to respiratory insufficiency [Kocakusak et al.: Hernia 2005;9: 284-287]. However, BH is almost asymptomatic in adults and discovered only incidentally [Wilkins et al.: Clin Imaging 1994;18: 224-229]. Complicated BH in adults might present with visceral incarceration and lethal complications. Upper gastrointestinal bleeding and acute pancreatitis are rarely reported in the literature as complications of BH in adults...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626373/biliary-pleural-fistula-following-portal-vein-embolization-for-perihilar-cholangiocarcinoma
#16
Mujtaba Mohammed, Katsuhiro Kobayashi, Mohammed Jawed
Biliary-pleural fistula (BPF), an abnormal communication between the biliary tract and pleural space, is a rare but potentially life-threatening complication following percutaneous biliary intervention. We report a case of BPF following portal vein embolization (PVE) in a 79-year-old woman with obstructive jaundice secondary to perihilar cholangiocarcinoma. The patient successfully underwent right-sided PVE; however, the patient developed a symptomatic right-sided bilious pleural effusion the following day...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626372/acute-appendicitis-caused-by-previous-endoscopic-submucosal-dissection-for-an-adenoma-adjacent-to-the-appendiceal-orifice
#17
Ryo Kato, Keita Harada, Kei Harada, Daisuke Takei, Yuusaku Sugihara, Shiho Takashima, Toshihiro Inokuchi, Masahiro Takahara, Sakiko Hiraoka, Yasushi Omura, Wakako Oda, Hiroyuki Okada
Endoscopic submucosal dissection (ESD) is a groundbreaking treatment for tumors adjacent to the appendiceal orifice that are difficult to remove by conventional endoscopic mucosal resection, and successful cases are increasingly reported. However, little is known about the subsequent complications, especially long-term complications. A female in her early 70s with a 15-mm cecal tumor adjacent to the appendiceal orifice - discovered incidentally during a screening colonoscopy - underwent hybrid ESD of the lesion...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626371/carcinoma-of-the-papilla-of-vater-after-diversion-operation-for-pancreaticobiliary-maljunction
#18
Takahiro Yamanaka, Kenichiro Araki, Norihiro Ishii, Mariko Tsukagoshi, Takamichi Igarashi, Akira Watanabe, Norio Kubo, Hiroyuki Kuwano, Ken Shirabe
Pancreaticobiliary maljunction (PBM) is a congenital malformation that is associated with biliary cancer development. When patients are diagnosed with PBM, a diversion operation is recommended. Although a risk remains for developing residual bile duct carcinoma following diversion, the development of a carcinoma of the ampulla of Vater after a diversion operation for PBM is rare. We present a treated case of carcinoma of the ampulla of Vater after a diversion operation for PBM. A 65-year-old woman presented with abdominal pain...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28638315/acute-abdomen-a-rare-case-of-ruptured-hepatocellular-carcinoma
#19
Severin Gloor, Kai Oliver Jensen, Stefan Breitenstein, Christoph A Binkert, Eliane Angst, Franc Heinrich Hetzer
Spontaneous ruptures of hepatocellular carcinoma (HCC) are rare. Nevertheless they may lead to difficult decisions in the emergency situation. The acute therapies include conservative treatment, transarterial embolization and surgery. Curative treatment of HCC can be achieved by liver resection solely. The decision-making depends on prognostic patient's factors, such as hepatic viral infection status, Child-Pugh grade, liver cirrhosis and number of tumors. In this case transarterial embolization was preferable as a bridging therapy prior to further diagnostics and therapy, to lower the perioperative morbidity and mortality...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28611570/development-and-improvement-of-simple-colonic-mucosal-ulcer-during-treatment-of-severe-ulcerative-colitis-with-tacrolimus
#20
Ayumi Ito, Bunei Iizuka, Teppei Omori, Shinichi Nakamura, Katsutoshi Tokushige
Diarrhea, melena, and lower abdominal pain developed in a male in his 20s and colonoscopy showed pancolitis-type severe ulcerative colitis (UC). Treatment was initiated with 4,000 mg of 5-aminosalicylic acid and 60 mg/day of prednisolone, but the symptoms and inflammatory reaction worsened with prednisolone dose reduction. Tacrolimus was added to the treatment, which subsequently induced remission. Serial colonoscopies during the treatment showed improvement in ulcer and mucosal edema throughout the entire large intestine, but a new solitary round ulcer appeared at the end of the ileum...
January 2017: Case Reports in Gastroenterology
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