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Case Reports in Gastroenterology

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https://www.readbyqxmd.com/read/28203139/spontaneous-splenic-infarcts-in-a-cirrhotic-patient-with-primary-biliary-cirrhosis
#1
Fredy Nehme, Kyle Rowe, Ahmad Haris, Imad Nassif
Spontaneous splenic infarction has been rarely reported as a complication of cirrhosis and portal hypertension. We describe the case of a 67-year-old female with past medical history of primary biliary cirrhosis presenting for a 1-day history of left upper quadrant pain. Investigations were in favor of splenic infarcts secondary to portal hypertension. The patient improved with conservative management and no recurrence was noted on further follow-up. Splenic infarction must be kept in mind when a patient with cirrhosis presents with left upper quadrant abdominal pain without a clear source...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203138/lupus-gastrointestinal-tract-vasculopathy-lupus-enteritis-involving-the-entire-gastrointestinal-tract-from-esophagus-to-rectum
#2
Joseph Bert, Elie Gertner
Gastrointestinal symptoms are very common in systemic lupus erythematosus (SLE). Lupus "enteritis" is very responsive to treatment but can have devastating consequences if not detected. Most descriptions of enteritis involve the small and large bowel. This is the first report of lupus "enteritis" involving the entire gastrointestinal tract from the esophagus and stomach to the rectum. Lupus "enteritis" is another cause of upper gastrointestinal involvement in SLE (involving even the esophagus and stomach) in addition to involvement of the lower intestinal tract...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203137/comamonas-testosteroni-is-it-still-a-rare-human-pathogen
#3
Shaika Farooq, Rumana Farooq, Nahida Nahvi
Comamonas testosteroni (formally Pseudomonas testosteroni) is common environmental bacterium that is not part of the human microbiome. Since its identification as a human pathogen in 1987, numerous reports have drizzled in, implicating this organism for various infections. Although these organisms are of low virulence, some of their obscurity perhaps is due to the incapability of clinical laboratories to identify them. Most of the reported cases are bloodstream infections. We report a case of gastroenteritis caused by this organism in a 65-year-old female with colostomy in situ...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203136/massive-hemorrhage-from-ectopic-duodenal-varices-importance-of-a-multidisciplinary-approach
#4
Tyler House, Patrick Webb, Chad Baarson
Duodenal variceal bleeding is an uncommon complication of portal hypertension that can easily go unrecognized and reach mortality rates as high as 40%. Cirrhosis is the most common cause of duodenal varices. In most cases, duodenal varices occur concomitantly with esophageal varices, further complicating identification with initial endoscopy. Although many modalities have been explored with respect to management and treatment approaches, guidelines have yet to be established owing to the infrequency in which bleeding occurs from ectopic duodenal varices...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203135/successful-treatment-of-hepatocellular-carcinoma-complicated-by-fanconi-anemia
#5
Koji Takahashi, Eiichiro Suzuki, Masayuki Yokoyama, Masanori Inoue, Toru Wakamatsu, Tomoko Saito, Yuko Kusakabe, Sadahisa Ogasawara, Yoshihiko Ooka, Akinobu Tawada, Yuhei Nagao, Chiaki Nakaseko, Tetsuhiro Chiba
A 42-year-old woman with liver tumors was referred to our hospital. Her condition was complicated by Fanconi anemia, and she had undergone total laryngectomy 8 years ago. On admission, contrast-enhanced computed tomography revealed hypervascular tumors in the right hepatic lobe. Ultrasound-guided tumor biopsy revealed that the tumor comprised moderately differentiated hepatocellular carcinoma. Although the patient exhibited preserved liver function (Child-Pugh A), complete blood count revealed severe pancytopenia...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203134/black-cohosh-hepatotoxicity-with-autoimmune-hepatitis-presentation
#6
Diana L Franco, Santosh Kale, Dora M Lam-Himlin, M Edwyn Harrison
Herbal medicines have been used for the treatment of various ailments since time immemorial. Black cohosh (BC) is well known for the treatment of postmenopausal symptoms, with conflicting evidence supporting its safety and benefits. We present a rare case of BC-induced autoimmune hepatitis (AIH) with hepatotoxicity in a 69-year-old female. To our knowledge, this represents the third case of BC-induced AIH.
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203133/simultaneously-diagnosed-and-successfully-treated-rectovaginal-and-vesicovaginal-fistulae-after-low-anterior-resection-with-concomitant-resection-of-female-genitalia
#7
Chisato Takagi, Hideo Baba, Kazuo Yamafuji, Atsunori Asami, Kaoru Takeshima, Nobuhiko Okamoto, Hidena Takahashi, Kiyoshi Kubochi
Rectovaginal fistula (RVF) and vesicovaginal fistula (VVF) are infrequent but distressing complications after pelvic surgery. However, their adequate treatment is not well described. Here, we simultaneously encountered and successfully treated RVF and VVF after radical surgery for rectal cancer. A 70-year-old woman underwent low anterior resection (LAR) combined with resection of the uterus, the bilateral adnexa, and the upper side of the vagina, as well as diverted ileostomy for rectal cancer. A month after the surgery, she developed urinary incontinence and underwent medical treatment, but her symptoms did not improve...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203132/modified-devine-exclusion-for-unresectable-distal-gastric-cancer-in-symptomatic-patients
#8
María Carmen Fernández-Moreno, Roberto Martí-Obiol, Fernando López, Joaquín Ortega
BACKGROUND: In patients with outlet obstruction syndrome and/or severe anemia secondary to unresectable gastric cancer (GC), partial stomach-partitioning gastrojejunostomy, or modified Devine exclusion, is a surgical alternative. METHODS: A retrospective study was conducted on patients with unresectable distal GC treated with modified Devine exclusion as palliative surgery between February 2005 and December 2015. It consisted of a series of 10 patients with outlet obstruction syndrome and/or severe anemia...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203131/brunner-s-gland-adenoma-a-rare-cause-of-gastrointestinal-bleeding-case-report-and-systematic-review
#9
Michele Sorleto, Annette Timmer-Stranghöner, Helge Wuttig, Oliver Engelhard, Carsten Gartung
Brunner's gland adenoma is an extremely rare benign small bowel neoplasm, often discovered incidentally during upper gastrointestinal endoscopy or radiological diagnostics. In few cases, it tends to cause gastrointestinal hemorrhage or intestinal obstruction. We report here our experience with a 47-year-old woman with a Brunner's gland adenoma of more than 6 cm in size, located in the first part of the duodenum and causing gastrointestinal bleeding. Initially, we performed a partial endoscopic resection using endoloop and snare alternatively to prevent severe bleeding...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203130/agenesis-of-the-gallbladder-role-of-clinical-suspicion-and-magnetic-resonance-to-avoid-unnecessary-surgery
#10
Eugenio Tagliaferri, Heinrich Bergmann, Sebastian Hammans, Aziz Shiraz, Eckhard Stüber, Christoph Seidlmayer
Isolated agenesis of the gallbladder is usually a rare asymptomatic anatomical variation, with an estimated incidence of 10-65 per 100,000. Females are more commonly affected (ratio 3: 1), with the disease typically presenting in the second or third decade of their life. Despite an absent gallbladder, half of the patients present with symptoms similar to biliary colic, which is poorly understood. The rarity of this condition combined with its clinical and radiological features often lead to a wrong preoperative diagnosis so that many patients undergo unnecessary operative intervention...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203129/plasmapheresis-for-refractory-pruritus-due-to-drug-induced-cholestasis
#11
Hasan Al-Azzawi, Ruchi Patel, Gagan Sood, Sumit Kapoor
Pruritus can be a distressing symptom seen in various cholestatic disorders. It is treated with medications like bile acid sequestrants. Drug-induced cholestasis usually resolves with withdrawal of the causative medication. We describe a case of refractory pruritus due to drug-induced cholestasis, not improved with withdrawal of the drug, managed effectively with multiple sessions of plasmapheresis.
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203128/liver-transplantation-for-unresectable-metastases-from-colon-adenocarcinoma
#12
Luis Armando Caicedo, Diego Buitrago, Laura S Thomas, Jorge I Villegas, Mauricio Duque, Oscar Serrano, Ana M Arrunategui, Juan Guillermo Restrepo, Gabriel Jaime Echeverri
Liver transplantation is an option that improves quality of life and prolongs life expectancy in patients with different types of liver disease. Liver transplantation is controversial for colorectal metastases and is not recommended in clinical practice guidelines. In this case report, we present, to our knowledge, the first liver transplantation for colorectal metastases conducted in Colombia, with a successful follow-up of more than 2 years. Patients with these characteristics who underwent liver transplantation experience reduced mortality and exponentially improved quality of life...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203127/a-case-of-mysterious-impacted-duodenal-foreign-body-presenting-with-halitosis
#13
Bhavtosh Dedania, Dipen Khanapara, Amruta Panwala, Murali Dharan
The majority of gastrointestinal (GI) foreign bodies (FBs) discovered in adults are the result of intentional ingestion, most of which are found in patients with a preexisting psychiatric illness, with substance abuse disorders, or in people seeking secondary gain. No similar case of internal injuries following unintentional ingestion of a barbecue grill cleaning brush bristle has been reported. A 58-year-old Caucasian male with no significant history presented with complaint of halitosis, not improving after oral care and dental hygiene measures...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203126/an-unusual-case-of-rectal-and-ileal-carcinoid-tumors
#14
Molham Abdulsamad, Naeem Abbas, Bhavna Balar
Carcinoid tumor is the most common neuroendocrine tumor affecting the gastrointestinal tract. The coexistence of multifocal carcinoid lesions is a well-established phenomenon. Although intubation of the terminal ileum is not routinely attempted during colonoscopy, it can occasionally reveal the presence of some incidental findings. We present a patient with known rectal carcinoid, who was found to have another carcinoid lesion in the terminal ileum during surveillance colonoscopy. The patient underwent right hemicolectomy, and no chemotherapy was required as the patient was found to have stage 1 carcinoid tumor...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203125/migration-of-surgical-clips-into-the-common-bile-duct-after-laparoscopic-cholecystectomy
#15
Krishn Kant Rawal
Laparoscopic cholecystectomy (LC) is currently the treatment of choice for symptomatic gallstones. Associated complications include bile duct injury, retained common bile duct (CBD) stones, and migration of surgical clips. Clip migration into the CBD can present with recurrent cholangitis over a period of time. Retained CBD stones can be another cause of recurrent cholangitis. A case of two surgical clips migrating into the common bile duct with few retained stones following LC is reported here. The patient had repeated episodes of fever, pain at epigastrium, jaundice, and pruritus 3 months after LC...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203124/when-diarrhea-can-become-deadly-legionnaires-disease-complicated-by-bowel-obstruction
#16
Wesley Prichard, Laurel Fick
Legionnaires' disease may present with a broad spectrum of illnesses and nonspecific extrapulmonary symptoms including diarrhea. To our knowledge, bowel obstruction has not been reported as a manifestation of Legionella. We present a unique case of Legionnaires' disease contributing to a small bowel obstruction.
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203123/spontaneous-isolated-superior-mesenteric-artery-dissection
#17
Anand Nath, Sayali Yewale, Mohammad Kousha
A true isolated superior mesenteric artery (SMA) dissection is a rare occurrence. The increasing use of diagnostic imaging studies has resulted in this rare disease being more recognized. A 68-year-old Caucasian female presented with sharp upper abdominal pain. Computed tomography (CT) of the abdomen showed dissection with thrombosis in the proximal SMA. Conservative management with bowel rest, blood pressure control, and anticoagulation relieved her symptoms. Follow-up CT showed stable dissection. Physicians should consider the diagnosis of isolated spontaneous SMA dissection after excluding more common causes...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100999/colorectal-cancer-associated-with-streptococcus-anginosus-bacteremia-and-liver-abscesses
#18
Umair Masood, Anuj Sharma, Dhruv Lowe, Rashad Khan, Divey Manocha
Streptococcus anginosus is part of the normal flora of the human gastrointestinal tract. Their ability to cause abscesses is very unique and sets them apart from the rest of the streptococci groups. While an association of group D streptococcus bacteremia and endocarditis with colorectal carcinoma is well established, S. anginosus infections are rarely implicated with colonic malignancy. We present a case of a 62-year-old male who presented to the hospital with fatigue and generalized abdominal pain. Computed tomography of the abdomen revealed multiple liver abscesses and rectal thickening...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100998/a-man-with-pancreatic-head-mass-lesion-on-endoscopic-ultrasound-and-granuloma-on-cytopathology
#19
Neda Rad, Arash Heidarnezhad, Setareh Soheili, Amir Houshang Mohammad-Alizadeh, Arash Nikmanesh
Primary pancreatic lymphoma is an unlikely malignancy accounting for less than 0.5% of pancreatic tumors. Clinical presentation is often nonspecific and may be clinically misdiagnosed as pancreatic adenocarcinoma. Here we present an Iranian case of primary pancreatic lymphoma in a 47-year-old male suffering from jaundice and 20% weight loss. Endoscopic ultrasound revealed a mixed echoic mass lesion at the head of pancreas. The patient underwent endoscopic ultrasound-guided fine needle aspiration of solid pancreatic mass and histopathologic diagnosis revealed granuloma...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100997/a-rare-cause-of-dysphagia-to-remember-calcific-tendinitis-of-the-longus-colli-muscle
#20
Dominic M Colella, Fiorela Calderón Sandoval, David W Powers, Nimal Patel, Javier Sobrado
Longus colli tendinitis (LCT) is an acute inflammatory condition with symptoms typically consisting of acute neck pain and stiffness with or without dysphagia. Once more severe etiologies for these symptoms are ruled out, this self-limiting condition usually resolves spontaneously with nonsteroidal anti-inflammatory drugs and corticosteroids. We present a case of LCT that presented as acute neck pain, dysphagia, and odynophagia that rapidly resolved once diagnosed and treated with anti-inflammatory agents. Though exceedingly rare, LCT must be considered in the differential diagnosis of acute neck pain, dysphagia, and odynophagia when more common etiologies do not correlate with the clinical presentation...
September 2016: Case Reports in Gastroenterology
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