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Case Reports in Gastroenterology

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https://www.readbyqxmd.com/read/28100999/colorectal-cancer-associated-with-streptococcus-anginosus-bacteremia-and-liver-abscesses
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28100996/intrapancreatic-accessory-spleen-a-diagnosis-not-to-forget
#4
Susana Marques, Miguel Bispo, Lariño Noia
A 69-year-old male patient was incidentally diagnosed with a 5-mm lesion in the pancreatic tail by endoscopic ultrasound (EUS). After contrast-enhanced EUS and EUS-elastography, all imaging features were highly suggestive of a benign pancreatic solid lesion such as an intrapancreatic accessory spleen (IPAS) or a benign neuroendocrine tumor. Interposition of the splenic artery precluded EUS-guided fine-needle aspiration (FNA). When an asymptomatic pancreatic mass is detected, IPAS diagnosis should be considered, and, if EUS-FNA is infeasible, contrast-enhanced EUS and EUS-elastography are useful tools to differentiate a pancreatic benign lesion as IPAS from a malignancy, with avoidance of unnecessary surgery...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100995/a-rare-case-of-intraductal-papillary-mucinous-neoplasm-of-the-biliary-duct-in-a-patient-with-prostate-adenocarcinoma
#5
Ravish Parekh, Gregory Krol, Cyrus Piraka, Surinder Batra
Intraductal papillary mucinous neoplasms (IPMNs) are mucin-producing papillary neoplasms of the pancreatic or biliary ductal system that exhibit variable cellular atypia and cause ductal dilation. There are few reported cases of IPMN arising from the biliary tree in the literature. It has a higher propensity to undergo malignant transformation compared to IPMN arising from the pancreatic duct. An 80-year-old male underwent cross-sectional tomography (CT) imaging of the abdomen for evaluation of prostate adenocarcinoma, which revealed an incidental 2...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100994/reocclusion-after-self-expandable-metallic-stent-placement-for-relieving-malignant-colorectal-obstruction-as-a-palliative-treatment
#6
Toshikatsu Nitta, Kensuke Fujii, Yoshimasa Hirata, Tomo Tominaga, Yoshihiro Inoue, Hiroshi Kawasaki, Ken Kawakami, Takashi Ishibashi
Self-expandable metallic stent (SEMS) placement has been practiced in several hospitals in Japan, including ours, since January 2012. Here, we report the case of an 82-year-old Japanese man who presented to the hospital with a 1-week history of right hypochondrial pain. Computed tomography (CT) findings indicated colorectal cancer. The laboratory findings on admission indicated severe anemia (red blood cell count, 426 × 104/μL; hemoglobin, 7.9 g/dL). We performed SEMS placement because the patient refused to undergo surgery...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100993/cdc-group-eo-4-and-candida-tropicalis-peritonitis-in-a-patient-on-peritoneal-dialysis-after-upper-endoscopy-colonoscopy-and-coil-embolization-of-the-gastroduodenal-artery
#7
Shameek Gayen, Yonah Ziemba, Shikha Jaiswal, Adam Frank, Yasmin Brahmbhatt
Peritoneal dialysis (PD) is an excellent form of renal replacement therapy for many patients with end-stage renal disease (ESRD). Over 10,000 patients receive PD in the United States [United States Renal Data System: 2015 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States, 2015]. PD has superior outcomes compared to hemodialysis in the first 2 years of ESRD [Sinnakirouchenan and Holley: Adv Chronic Kidney Dis 2011;18: 428-432]. However, peritonitis is a known complication and may result in significant morbidity and necessitate transition to hemodialysis, which increases medical costs [Holley and Piraino: Semin Dial 1990;3: 245-248]...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100992/multiple-magnetic-foreign-bodies-causing-severe-digestive-tract-injuries-in-a-child
#8
Xinmin Si, Baofeng Du, Lei Huang
Foreign body (FB) ingestion is a common emergency as well as a major cause of accidental injury and represents a severe public health problem in childhood, especially in infants. Most cases of FB ingestion reported in children aged between 6 months and 3 years depend primarily on the fact that young children are more likely to explore objects using their mouth and are not able to distinguish edible objects from nonedible ones, their teeth are physiologically lacking, and they have poor swallowing coordination...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100991/sphincter-of-oddi-dysfunction-a-perplexing-presentation
#9
Sana Ahmad Din, Iman Naimi, Mirza Beg
Sphincter of Oddi dysfunction is caused by stenosis or dyskinesia of the sphincter of Oddi, leading to blockage of bile drainage from the common bile duct. We present the case of a 16-year-old female with chronic abdominal pain who underwent laparoscopic cholecystectomy for cholelithiasis but continued to experience abdominal pain, nausea, and vomiting along with persistently elevated ALT and AST levels. Postoperative abdominal ultrasound was nondiagnostic. Esophagogastroduodenoscopy showed mild reflux esophagitis and mild chronic Helicobacter pylori-negative gastritis...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100990/drug-induced-liver-injury-associated-with-complementary-and-alternative-medicines
#10
Koji Takahashi, Tatsuo Kanda, Shin Yasui, Yuki Haga, Junichiro Kumagai, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Masato Nakamura, Makoto Arai, Osamu Yokosuka
A 24-year-old man was admitted due to acute hepatitis with unknown etiology. After his condition and laboratory data gradually improved with conservative therapy, he was discharged 1 month later. Two months after his discharge, however, liver dysfunction reappeared. After his mother accidentally revealed that he took complementary and alternative medicine, discontinuation of the therapy caused his condition to improve. Finally, he was diagnosed with a recurrent drug-induced liver injury associated with Japanese complementary and alternative medicine...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27990104/hepatic-encephalopathy-due-to-congenital-multiple-intrahepatic-portosystemic-venous-shunts-successfully-treated-by-percutaneous-transhepatic-obliteration
#11
Shinsuke Takenaga, Kenichi Narita, Yo Matsui, Kunihiko Fukuda
Hepatic encephalopathy due to intrahepatic portosystemic venous shunts (IPSVS) in a non-cirrhotic condition is rare. Here we report a rare case of a patient with congenital multiple IPSVS successfully treated by percutaneous transhepatic obliteration. The patient was a 67-year-old woman who presented to our hospital with progressive episodes of consciousness disorder and vomiting. Laboratory tests revealed hyperammonemia (192.0 μg/dL), and computed tomography revealed multiple IPSVS in both lobes. There was no evidence of underlying liver disease or hepatic trauma...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27990103/two-cases-of-rectal-neuroendocrine-tumor-resection-combined-with-dissection-of-the-circular-muscle-layer-using-the-endoscopic-submucosal-dissection-technique
#12
Kumpei Honjo, Kazumasa Kure, Ryosuke Ichikawa, Hisashi Ro, Rina Takahashi, Koichiro Niwa, Shun Ishiyama, Kiichi Sugimoto, Hirohiko Kamiyama, Makoto Takahashi, Yutaka Kojima, Michitoshi Goto, Yuichi Tomiki, Kazuhiro Sakamoto, Yuki Fukumura, Takashi Yao
Generally, lesions of rectal neuroendocrine tumors (NETs) 10 mm or smaller are less malignant and are indicated for endoscopic therapy. However, the vertical margin may remain positive after conventional endoscopic mucosal resection (EMR) because NETs develop in a way similar to submucosal tumors (SMTs). The usefulness of EMR with a ligation device, which is modified EMR, and endoscopic submucosal dissection (ESD) was reported, but no standard treatment has been established. We encountered 2 patients in whom rectal NETs were completely resected by combined dissection and resection of the circular muscle layer using the ESD technique...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920662/possible-noninvasive-biomarker-of-eosinophilic-esophagitis-clinical-and-experimental-evidence
#13
Sathisha Upparahalli Venkateshaiah, Murli Manohar, Alok K Verma, Uwe Blecker, Anil Mishra
Eosinophilic esophagitis (EoE) diagnosis and follow-up response to therapy is based on repeated endoscopies and histological examination for eosinophils/HPF. The procedure is invasive and risky in particular for the pediatric population. Presently, there is no highly sensitive and specific noninvasive blood test available to monitor the disease pathogenesis. Reports indicate the expression of PDL1 (CD274) on the eosinophils in allergic patients. Herein, we report that CD274-expressing and -nonexpressing eosinophils were detected in both examined pediatric and adult EoE patients...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920661/endoscopic-removal-of-a-duodenal-perforating-leg-of-glasses-with-dormia-basket
#14
Li Wang, Wei Wen, Jiamiao Huang, Weijie Hu, Renrong Zhou, Xin Li, Xiaojiang Wang
Ingestion of foreign bodies is common in clinical practice. Most ingested foreign bodies will pass through the gastrointestinal (GI) tract without any problems. While GI tract injury due to the ingested foreign body such as a toothpick, a fishbone, a date pit, or a chicken bone, is common, duodenal perforation is rare. In this report, our experience with this rare entity is shared. We present a 38-year-old male patient with GI tract perforation in the bulbus of the duodenum due to a leg of glasses. The patient was admitted to our hospital with severe abdominal pain...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920660/neurofibroma-of-the-colon-a-diagnostic-mimicker-of-gastrointestinal-stromal-tumor
#15
Soomin Ahn, Choon Sik Chung, Kyoung-Mee Kim
Gastrointestinal neurofibroma usually develops as diffuse gastrointestinal involvement in neurofibromatosis type 1 patients. Only 4 cases of sporadic colonic neurofibroma in a patient without neurofibromatosis type 1 have been reported in the English literature. A 26-year-old female patient underwent colonoscopy, and a 4-cm-sized polypoid mass was identified in the sigmoid colon. Wedge resection of the mass showed a yellowish, hard submucosal tumor. Microscopically, the tumor was composed of wavy spindle cells, fibroblasts, and strands of collagen; the stroma showed scattered myxoid areas...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920659/obscure-gastrointestinal-bleeding-due-to-a-small-intestinal-gastrointestinal-stromal-tumor-in-a-young-adult
#16
Mami Yamamoto, Kentaroh Yamamoto, Hirotaka Taketomi, Fumio Yamamoto, Hiroshi Yamamoto
The source of most cases of gastrointestinal bleeding is the upper gastrointestinal tract. Since bleeding from the small intestine is very rare and difficult to diagnose, time is required to identify the source. Among small intestine bleeds, vascular abnormalities account for 70-80%, followed by small intestine tumors that account for 5-10%. The reported peak age of the onset of small intestinal tumors is about 50 years. Furthermore, rare small bowel tumors account for only 1-2% of all gastrointestinal tumors...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920658/isolated-bilateral-gastrocnemius-myositis-in-crohn-disease-successfully-treated-with-adalimumab
#17
Salvatore Vadala di Prampero, Marco Marino, Francesco Toso, Claudio Avellini, Vu Nguyen, Dario Sorrentino
Extraintestinal manifestations are common in inflammatory bowel disease; however, muscular involvement in Crohn disease is rarely reported. We present a case of a 26-year-old male with ileocolonic Crohn disease who developed sudden tenderness in both calves. Doppler ultrasound was negative for deep vein thrombosis. Magnetic resonance imaging of the gastrocnemius muscle showed high intensity signal in the muscle fibers, and muscle biopsy demonstrated nonspecific lymphocytic myositis. Other relevant laboratory results included normal antineutrophil cytoplasmic antibodies and creatine kinase as well as elevated C-reactive protein, erythrocyte sedimentation rate, and anti-Saccharomyces cerevisiae IgG titer...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920657/disseminated-histoplasmosis-a-challenging-differential-diagnostic-consideration-for-suspected-malignant-lesions-in-the-digestive-tract
#18
Bernhard Doleschal, Therese Rödhammer, Oleksiy Tsybrovskyy, Karl J Aichberger, Franz Lang
Histoplasmosis is well characterized as an endemic fungal disease restricted to certain areas of the USA. In Middle Europe, most patients present with acute pulmonary symptoms after travelling to endemic areas. Here, we want to illustrate the case of a 67-year-old man who presented with persistent oral ulcers, hoarseness, dysphagia, diarrhea, and weight loss to our Department of Otorhinolaryngology in December 2014. He was a retired construction worker and had a history of soil-disruptive activities in Africa and Middle and South America during employment...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920656/successful-transanal-removal-of-a-rectal-foreign-body-by-abdominal-compression-under-endoscopic-and-x-ray-fluoroscopic-observation-a-case-report
#19
Hironobu Mikami, Norihisa Ishimura, Akihiko Oka, Ichiro Moriyama, Takafumi Yuki, Kousaku Kawashima, Shuichi Sato, Shunji Ishihara, Yoshikazu Kinoshita
We occasionally encounter patients with various types of rectal foreign bodies. When too large to grasp, transanal removal can be difficult. Here, we report a case of successful manual transanal removal of an 18 × 4 × 4 cm silicon rod without complications. A 50-year-old male came to the emergency department of our hospital 12 h after transanal insertion of a whole silicon rod. An abdominal examination showed no evidence of peritonitis, while X-ray and computed tomography findings revealed a large foreign body in the rectum, without any sign of perforation...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920655/deep-vein-thrombosis-as-initial-manifestation-of-whipple-disease
#20
Mônica Souza de Miranda Henriques, Alexandre Rolim da Paz, Ana Beatriz Person Gaertner, Cibelle Ingrid Stephen Melo, Priscyanne Lins Filgueiras, Rafaella Alencar Jerome
INTRODUCTION: Wipple disease (WD) is a rare chronic disease caused by the bacillus Tropheryma whipplei. Constitutive, rheumatologic, gastrointestinal, cardiac, cerebral, lymphatic, cutaneous, and ophthalmological signs are possible systemic symptoms. However, thrombotic manifestations are rarely described as "stroke-like syndrome" or arterial thrombosis. Diagnosis is based on clinical manifestations and pathological examination. Laboratory findings may include anemia, leukocytosis, and thrombocytosis...
September 2016: Case Reports in Gastroenterology
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