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Case Reports in Gastroenterology

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https://www.readbyqxmd.com/read/27920662/possible-noninvasive-biomarker-of-eosinophilic-esophagitis-clinical-and-experimental-evidence
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/27920654/a-rare-cause-of-pulmonary-nodules
#9
Michael Tsuyoshi Chew, Eric Chak, Karen Matsukuma
Crohn's disease is a chronic, idiopathic autoimmune disorder that primarily targets the gastrointestinal (GI) system. It is characterized by transmural inflammation of the GI tract that can occur anywhere from the mouth to the anus. Not infrequently, the disease may also have extraintestinal manifestations (EIMs) that can affect almost any organ system. It is estimated that EIMs affect up to 36% of patients with Crohn's disease, but the incidence and prevalence of pulmonary involvement are variable in the literature and may be as low as 0...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920653/intestinal-bacterial-infection-diagnosed-by-histological-examination-of-endoscopic-biopsy-specimens
#10
Michiko Yuki, Yuko Emoto, Katsuhiko Yoshizawa, Takashi Yuri, Airo Tsubura
Intestinal spirochetosis (IS) in humans is characterized by spirochetal microorganisms attached to the luminal surface of the colonic epithelium. In the present case, attached organisms appeared as 3- to 4 μm-thick (average thickness, 3.4 μm) basophilic fringes or haze in HE-stained endoscopic biopsy specimens. The basophilic fringes were clearly labeled by Treponema pallidum antiserum. Because IS is relatively rare in developed countries, thin basophilic fringes characteristic of IS are readily overlooked...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920652/diffuse-infiltrative-hepatocellular-carcinoma-with-portal-vein-tumor-thrombosis-completely-cured-by-transcatheter-arterial-chemoembolization-case-report-with-8-year-follow-up
#11
Suk Bae Kim
Hepatocellular carcinoma (HCC) is the most common type of liver cancer and its treatment options are determined by shape, liver function, loci, and stages of cancer. Diffuse type of infiltrative HCC accompanied by portal vein tumor thrombosis (PVTT) has the poorest prognosis among other HCCs and there are no other prominent treatment options than systemic chemotherapy. In this study, we report a case of a 56-year-old man with diffuse infiltrative HCC accompanied by PVTT who achieved complete remission for 8 years after receiving conventional transcatheter arterial chemoembolization using adriamycin and gelfoam...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920651/use-of-direct-acting-antivirals-for-the-treatment-of-hepatitis-c-virus-associated-oral-lichen-planus-a-case-report
#12
Kenji Misaka, Takashi Kishimoto, Yuji Kawahigashi, Michio Sata, Yumiko Nagao
Hepatitis C virus (HCV) is frequently associated with various extrahepatic manifestations such as autoimmune features and immune complex deposit diseases. Oral lichen planus (OLP) is one of the representative extrahepatic manifestations of HCV infection. Direct-acting antivirals (DAA) are highly effective and safe for the eradication of HCV. However, there is a lack of information regarding the association between HCV-associated OLP and interferon (IFN)-free DAA therapy. Herein, we present the case of a 60-year-old female who was diagnosed with OLP during routine periodontal treatment by a dentist...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920650/trichotillomania-in-celiac-disease
#13
Abeer Ayad Al Lihabi
Trichotillomania is an underreported and underdiagnosed condition associated with significant impairments in social and functional relationships. The connection between celiac disease and trichotillomania is not yet established clearly. Only a few cases of trichotillomania have been reported to date. Here, we report the case of a 22-year-old Saudi female, who presented with celiac disease and trichotillomania to the psychiatry clinic. This is the first report of its kind in Saudi Arabia. By reporting this case, I highlight the importance of psychiatric and comprehensive approaches in patients with celiac disease...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920649/hepatoid-carcinoma-of-the-pancreas-case-report-next-generation-tumor-profiling-and-literature-review
#14
James M Chang, Nitin N Katariya, Dora M Lam-Himlin, Danielle J Haakinson, Ramesh K Ramanathan, Thorvardur R Halfdanarson, Mitesh J Borad, Rahul Pannala, Douglas Faigel, Adyr A Moss, Amit K Mathur
Fewer than 25 cases of hepatoid carcinoma of the pancreas have been reported in the literature. We present a case in a 61-year-old male with a remote history of Hodgkin's lymphoma and gastric neuroendocrine cell hyperplasia. On surveillance endoscopic ultrasound, an 8 × 5 mm cystic lesion was seen in the tail of the pancreas. MRI showed a focal pancreatic duct cut-off with mild ductal dilation. Fine needle aspiration was performed, which was concerning for acinar cell carcinoma. The patient underwent distal pancreatectomy and recovered uneventfully...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920648/synchronous-adenocarcinoma-of-the-colon-and-rectal-carcinoid
#15
Vamshidhar Vootla, Rafeeq Ahmed, Masooma Niazi, Bhavna Balar, Suresh Nayudu
Primary colonic adenocarcinoma and synchronous rectal carcinoids are rare tumors. Whenever a synchronous tumor with a nonmetastatic carcinoid component is encountered, its prognosis is determined by the associate malignancy. The discovery of an asymptomatic gastrointestinal carcinoid during the operative treatment of another malignancy will usually only require resection without additional treatment and will have little effect on the prognosis of the individual. This article reports a synchronous rectal carcinoid in a patient with hepatic flexure adenocarcinoma...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920647/febrile-neutropenia-with-thrombocytopenia-after-infliximab-induction-in-a-patient-with-ulcerative-colitis
#16
Gustavo Gomez, Shifa Umar, Mohammad Bilal, Cristina Strahotin, Kofi Clarke
A 34-year-old female with left-sided ulcerative colitis (UC) developed severe febrile neutropenia/thrombocytopenia soon after infliximab induction therapy. There was no other plausible cause of the cell line abnormalities other than an accurate temporal association with infliximab administration. Supportive care, broad-spectrum antibiotic, and single dose of filgrastim was given on day 5 of admission due to persistently low absolute neutrophil count and fevers. The cell lines recovered, fever resolved and the patient made a complete clinical recovery...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920646/successful-treatment-of-small-intestinal-bleeding-in-a-crohn-s-patient-with-noncirrhotic-portal-hypertension-by-transjugular-portosystemic-shunt-placement-and-infliximab-treatment
#17
Benjamin Heimgartner, Heather Dawson, Andrea De Gottardi, Reiner Wiest, Jan Hendrik Niess
Small intestinal bleeding in Crohn's disease patients with noncirrhotic portal hypertension and partial portal and superior mesenteric vein thrombosis is a life-threatening event. Here, a case is reported in which treatment with azathioprine may have resulted in nodular regenerative hyperplasia, portal hypertension and portal vein thrombosis. The 56-year-old patient with Crohn's disease developed nodular regenerative hyperplasia under treatment with azathioprine. He was admitted with severe bleeding. Gastroscopy showed small esophageal varices without bleeding stigmata...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920645/autoimmune-pancreatitis-a-case-of-atypical-radiographic-findings
#18
Shawhin Karimi, Parth Bharill
Autoimmune pancreatitis (AIP) is a rare pancreatic disorder that can present as a manifestation of a broader systemic inflammatory disease known as immunoglobulin G4-related systemic disease (IGG4-RSD). AIP is divided into two subtypes based on clinical, radiological, and histological findings. The disease can be mistaken for pancreatic cancer because of overlapping clinical and radiological findings, but early recognition can help avoid unnecessary surgery. We present a case of a 65-year-old female with suspected acute gallstone pancreatitis found to have AIP based on serology, radiological findings, and response to steroids...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920644/severe-acute-respiratory-distress-syndrome-during-infliximab-therapy-in-a-patient-with-crohn-disease
#19
Johanna Schoehl, Nicolae-Catalin Mechie, Harald Schwoerer, Onnen Moerer, Michael Quintel, Cordula Buck, Volker Ellenrieder, Albrecht Neesse, Ahmad Amanzada
The occurrence of a noninfectious interstitial lung disease is a rare but life-threatening side effect of infliximab, an antitumor necrosis factor alpha antibody. The following case report of a patient with Crohn disease shows an extremely dramatic progression to a severe acute respiratory distress syndrome.
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920643/elevated-lipase-during-initial-presentation-of-ulcerative-colitis-in-a-pediatric-patient-do-we-check-for-it
#20
Piyali Ray, Melissa R Van Arsdall
There are very few reports of elevated lipase in pediatric inflammatory bowel disease (IBD). Symptoms of pancreatitis may be masked by abdominal pain in pediatric IBD. During the initial presentation of IBD in our patient, lipase was elevated to more than 3 times the upper limit of normal. Normalization of values coincided with remission of IBD. This may be due to extraintestinal involvement of the pancreas as part of the inflammatory process or due to leakage of pancreatic enzymes from an inflamed gut or mediated by inflammatory cytokines...
September 2016: Case Reports in Gastroenterology
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