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Case Reports in Gastroenterology

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https://www.readbyqxmd.com/read/29681791/a-rare-multifocal-pattern-of-type-2-autoimmune-pancreatitis-with-negative-igg4-a-potential-diagnostic-pitfall-that-may-mimic-multifocal-pancreatic-adenocarcinoma
#1
Partha Hota, Tejas Patel, Xiaofeng Zhao, Nirag Jhala, Omar Agosto
Autoimmune pancreatitis (AIP) is an increasingly recognized form of acute pancreatitis characterized by obstructive jaundice with a rapid and dramatic treatment response to steroid therapy. Recently, AIP has been divided into two distinct phenotypes: lymphoplasmocytic sclerosing pancreatitis AIP (type 1) and idiopathic duct-centric pancreatitis AIP (type 2); each of which have their own distinct demographics, diagnostic criteria, and histopathological features. We report, to the best of our knowledge, the first case of a multifocal pattern of type 2 AIP characterized with both CT and MR imaging...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29606942/elbasvir-grazoprevir-an-alternative-in-antiviral-hepatitis-c-therapy-in-patients-under-amiodarone-treatment
#2
Lina Weiss, Kerstin Wustmann, Mariam Semmo, Markus Schwerzmann, Nasser Semmo
A sofosbuvir/ledipasvir combination is part of a first-line treatment of hepatitis C. However, in patients concurrently treated with amiodarone, cardiac side effects have been described, resulting in an official warning in 2015 by the American Food and Drug Administration and the European Medicines Agency when combining those substances. This deprived numerous hepatitis C patients with concurrent cardiovascular problems of receiving this highly effective treatment. Here we present a treatment alternative with an elbasvir/grazoprevir regimen, based on our successful treatment of a patient under concurrent amiodarone therapy...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29606941/a-surgically-resected-pancreatic-schwannoma-with-obstructive-jaundice-with-special-reference-to-differential-diagnosis-from-other-cystic-lesions-in-the-pancreas
#3
Takayoshi Watanabe, Kenichiro Araki, Norihiro Ishii, Takamichi Igarashi, Akira Watanabe, Norio Kubo, Hiroyuki Kuwano, Ken Shirabe
Pancreatic schwannomas are uncommon. About 60% of pancreatic schwannomas develop cystic lesions, and the differential diagnosis from other cystic pancreatic tumors is difficult. A 43-year-old man presented for evaluation of liver dysfunction detected during a medical checkup. Blood testing detected obstructive jaundice. A computed tomography scan revealed a well-defined polycystic tumor of about 5 cm at the pancreatic head. We performed surgical resection to treat the patient's symptoms and facilitate long-term management...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29606940/successful-fecal-microbiota-transplantation-in-a-patient-with-severe-complicated-clostridium-difficile-infection-after-liver-transplantation
#4
REVIEW
Kai Markus Schneider, Theresa H Wirtz, Daniela Kroy, Stefanie Albers, Ulf Peter Neumann, Till Strowig, Gernot Sellge, Christian Trautwein
Clostridium difficile infection (CDI) represents one of the most common healthcare-associated infections. Due to increasing numbers of recurrences and therapy failures, CDI has become a major disease burden. Studies have shown that fecal microbiota transplantation (FMT) can both be a safe and highly efficacious therapy for patients with therapy-refractory CDI. However, patients undergoing solid organ transplantation are at high risk for CDI due to long-term immunosuppression, previous antibiotic therapy, and proton pump inhibitor use...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29515347/a-bile-duct-stone-formation-around-a-fish-bone-as-a-nidus-after-pancreatoduodenectomy
#5
Tomoki Sakakida, Hideki Sato, Toshifumi Doi, Takumi Kawakami, Yoshikazu Nakatsugawa, Ken Nishimura, Shinya Yamada, Hideki Fujii, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida
We report a rare case of bile duct stone formation around an ingested fish bone as a nidus after pancreatoduodenectomy. A 78-year-old woman was admitted to our department for fever and epigastric pain. Abdominal computed tomography revealed an elongated bile duct stone containing a linearly shaped foreign body of bone density. Enteroscopic lithotomy was performed using single balloon enteroscopy to safely remove the stone and foreign body from the bile duct. The foreign body was determined to be a fish bone by pathological examination and component analysis...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29515346/ileum-histoplasmosis-mimicking-intestinal-tuberculosis-and-crohn-s-disease
#6
Xin-Bo Ai, Zhen-Jiang Wang, Qi-Chao Dong, Xu Lin, Yu-Ping Chen, Fei-Yue Gong, Hui Liang
Gastrointestinal histoplasmosis (GIH) without pulmonary and bone marrow involvement is very rare worldwide. It can be misdiagnosed as intestinal tuberculosis or Crohn's disease. There are just few case reports of GIH in patients with a positive HIV antibody test. Here, we report a patient who presented to our hospital with repeated intestinal obstruction. The suspicious diagnosis was intestinal tuberculosis or Crohn's disease due to unspecific clinical manifestations and radiologic images. Our patient's HIV antibody test was negative...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29515345/adult-presentation-of-noncirrhotic-portal-hypertension-and-ascites-following-treatment-for-wilms-tumor-in-childhood
#7
Linda Kievit, Pia Kræmer, Stephen Hamilton-Dutoit, Henning Grønbæk
A 37-year-old male, who at the age of 8 years had been treated for right-sided Wilms' tumor with nephrectomy, radiotherapy, and chemotherapy, presented with noncirrhotic portal hypertension (NCPH), grade 2 esophageal varices, and ascites. A CT scan demonstrated hypoplasia of liver segments 2 and 3. A liver biopsy showed portal tract fibrosis without cirrhosis, with histological features of NCPH. Liver vein catheterization showed a normal portal pressure gradient of 5 mm Hg while spleen to hepatic vein pressure was 29 mm Hg...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29515344/sevelamer-induced-gastrointestinal-injury-presenting-as-gastroenteritis
#8
Jared Magee, Matthew Robles, Peter Dunaway
End-stage renal disease (ESRD) is a common disease encountered in clinical practice and is associated with increasing metabolic derangements through disease progression. Phosphate retention is one of the most common derangements and is associated with increased mortality. Hyperphosphatemia becomes increasingly prevalent as glomerular filtration rate decreases. Non-calcium phosphate-binding resins and dietary phosphate restriction are the mainstays for managing hyperphosphatemia in patients with ESRD. Sevelamer carbonate is the most frequently used non-calcium phosphate binder in the US due to ease of administration and an excellent safety profile...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29515343/endoscopic-versus-laparoscopic-full-thickness-biopsy-in-the-pathological-evaluation-of-the-enteric-nervous-system
#9
Bodil Ohlsson, Rita J Gustafsson, Ervin Toth, Bèla Veress, Henrik Thorlacius
A full-thickness biopsy of the bowel wall is required to evaluate the enteric nervous system. A patient with aggravating gastrointestinal symptoms underwent a laparoscopic full-thickness biopsy of the ileum and, 1 year later, an endoscopic full-thickness biopsy of the sigmoid colon. Both samples showed enteric neuropathy characterized by vacuolated and enlarged neurons. The length of the myenteric plexus was greater in the endoscopic (23 mm) compared to the laparoscopic (11 mm) biopsy, with fewer tissue artefacts in the laparoscopic approach...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29515342/a-diminutive-t1-cancer-4-mm-in-size-resected-by-cold-snare-polypectomy
#10
Naohisa Yoshida, Yuji Naito, Takaaki Murakami, Kiyoshi Ogiso, Ryohei Hirose, Yutaka Inada, Mitsuo Kishimoto, Rafiz Abdul Rani, Yoshito Itoh
Cold snare polypectomy (CSP) should be performed for benign lesions, though an accurate diagnosis is sometimes difficult with only white light observation. Irregular findings by narrow-band imaging (NBI) are useful for differentiating malignant lesions from benign lesions, and cases with this finding are not expected for CSP. We present a diminutive T1 cancer resected by CSP as a reflection case. A 68-year-old man underwent colonoscopy for surveillance after polypectomy. A reddish polyp 4 mm in size was detected at the rectum...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29515341/spontaneous-rupture-of-hepatocellular-carcinoma-in-a-young-patient-with-fatal-outcome
#11
David F Pinal-García, Carlos M Nuño-Guzmán, Audrey Gómez-Abarca, Jorge L Corona, Ismael Espejo
Spontaneous rupture of hepatocellular carcinoma (HCC) is a potentially life-threatening complication. Diagnosis may be difficult, particularly in the absence of known liver cirrhosis or tumor. A 20-year-old male patient presented with progressive abdominal pain and shock. His past medical history was uneventful. Anemia, acute renal failure, and abnormal liver function test were demonstrated. Mild hepatomegaly, perihepatic and flank fluid, and multiple hypodense liver lesions suggestive of intrahepatic metastases or multifocal HCC were revealed by computed tomography...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29515340/severe-hepatic-and-pulmonary-involvement-in-rendu-osler-weber-syndrome
#12
Xavier Verhelst, Anja Geerts, Hans Van Vlierberghe, Peter Smeets, Clarisse Lecluyse
We report the case of a young woman with hereditary hemorrhagic telangiectasia (HHT) with severe liver involvement and pulmonary shunting. The medical imaging in this patient illustrates the severe shunting that can occur in these patients who often are asymptomatic. By showing this case, we want to highlight the role of liver transplantation in HHT with hepatic involvement.
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29515339/coexisting-granular-cell-tumor-and-tubular-adenoma-of-the-ileocecal-valve
#13
Jonathan Gapp, John Gross, Lakshmi Chintalacheruvu, Savio Reddymasu
Granular cell tumors (GCTs) have been described as neoplasms of Schwann cell origin. They are often benign and notably uncommon in the gastrointestinal tract. Recently, their incidence has become more common, likely as a result of increased colonoscopy screenings. Very few data exist regarding their potential for malignancy, but malignant GCTs have been reported. Here, we report the case of a young female patient who was diagnosed with an atypical GCT on the ileocecal valve with an overlying tubular adenoma which was found incidentally on colonoscopy...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29515338/ercp-related-duodenal-perforation-presenting-as-pneumoscrotum
#14
Mohammad Saud Khan, Faisal Jamal, Zubair Khan, Abhinav Tiwari, Hermann Simo, Himani Sharma
Duodenal perforation is a rare but life-threatening complication of endoscopic retrograde cholangiopancreatography (ERCP). Duodenal perforation can cause air leak into the extraperitoneal space. In rare instances, the air in the extraperitoneal space could dissect along the fascial planes of the abdomen to reach scrotum, leading to pneumoscrotum. We present the case of a 35-year-old male patient who developed scrotal pain and swelling following ERCP. He was found to have extensive pneumoscrotum, pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29606939/laparoscopic-resection-of-an-epithelial-cyst-in-an-intrapancreatic-accessory-spleen
#15
REVIEW
Kazuhiro Suzumura, Etsuro Hatano, Toshihiro Okada, Yasukane Asano, Naoki Uyama, Ikuo Nakamura, Seikan Hai, Nobutaka Ichikawa, Keiji Nakasho, Jiro Fujimoto
An epithelial cyst in an intrapancreatic accessory spleen (ECIAS) is rare. We herein report a case of a patient with ECIAS who underwent laparoscopic surgery. A 57-year-old woman was referred to our hospital because of a pancreatic tail tumor. She was asymptomatic, and a physical examination revealed no remarkable abnormalities. The levels of the tumor marker carbohydrate antigen 19-9 (CA19-9) and s-pancreas-1 antigen (SPan-1) were elevated. Ultrasonography showed a well-defined homogeneous cystic tumor. Computed tomography showed a well-demarcated cystic tumor in the pancreatic tail...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29606938/spontaneous-hepatitis-b-seroclearance-upon-development-of-hepatocellular-carcinoma
#16
Sara Naimimohasses, Omar El Sherif, Mohammad Ashfaq, Niamh Nolan, Masood Iqbal, Susan McKiernan, Suzanne Norris
The spontaneous seroclearance of hepatitis B upon development of a hepatocellular carcinoma (HCC) is extremely rare. To date, there has been one published case series reporting hepatitis B seroconversion following HCC resection. We describe two novel cases of spontaneous hepatitis B seroclearance following the development of HCC, prior to resection. Following resection, specimens were HBsAg- and HBcAg-negative in both tumor and peritumor tissues. Although the precise mechanism of this is poorly understood, nonuniform integration of hepatitis B virus DNA within the liver could lead to selective tumorigenesis of HBsAg-producing cells, explaining the observed clearance of serum HBsAg with the development of HCC...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29606937/adenosquamous-carcinoma-of-the-colon
#17
Tagore Sunkara, Megan E Caughey, Priyanka Makkar, Febin John, Vinaya Gaduputi
Overall, colorectal cancer is the third most commonly diagnosed cancer in both men and women, meaning that it is one of the more widely recognized preventable cancers. Instances of colorectal malignancies though are overwhelmingly attributable to adenocarcinoma. Colorectal cancers with components of squamous cell carcinoma represent a statistical anomaly. Here, we present the case of a 50-year-old male, who complained of abdominal pain and weight loss over a 3-month period of time. Biopsies from a colonoscopy ultimately revealed that this patient's colon cancer consisted of both adenocarcinoma and squamous cell carcinoma, representing a truly exceptional pathology finding in a patient diagnosed with a colorectal cancer...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29606936/vedolizumab-as-a-potential-culprit-in-the-development-of-ovarian-teratoma
#18
Judy A Trieu, Mohammad Bilal, Gurinder Luthra
Vedolizumab is a new humanized monoclonal antibody that has been reserved for those with moderate-to-severe Crohn's disease and ulcerative colitis who have failed immunomodulator and TNF-α antagonist therapy, and for those who have an increased risk for developing progressive multifocal leukoencephalopathy. Because it targets gastrointestinal tract-specific lymphocytes, meta-analyses and integrated studies have shown that vedolizumab causes fewer extraintestinal adverse effects, such as opportunistic infections and malignancies, compared with anti-TNF therapies...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29606935/eighteen-month-interval-growth-of-terminal-ileal-primary-adenocarcinoma-a-consideration-for-current-screening-guidelines
#19
REVIEW
Matthew Nazari, Alice Lee, Jared Rosenblum, Tilak Baba, Samuel Kallus
Primary adenocarcinoma of the small intestine comprises one of the rarest gastrointestinal malignancies. Further, the terminal ileum is very seldom implicated. This entity occurs sporadically and evades traditional colonoscopic evaluation in which the terminal ileum is not visualized. Herein, a case of interval development of primary terminal ileal adenocarcinoma over a 2-year period is reported as followed by direct endoscopic and colonoscopic visualization. This case demonstrates cecal involvement not found on initial evaluation without the provision of terminal ileum intubation...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29606934/vedolizumab-treatment-for-ulcerative-colitis-in-an-elderly-multimorbid-patient-with-hemophilia-a
#20
Holger Schäffler, Astrid Huth, Georg Lamprecht, Olaf Anders
The treatment of inflammatory bowel diseases (IBD) can be challenging, especially in elderly multimorbid patients. Since incidence and prevalence rates of IBD are rising steadily, treatment of older patients with relevant and also rare comorbidities will be of increasing relevancy for caregivers. Here we report on a 74-year-old multimorbid patient with severe ulcerative colitis (UC) and hemophilia A. Because of the chronic active disease, therapy with a tumor necrosis factor-α inhibitor was started. He suffered from a severe infectious complication (pneumonia) under therapy with infliximab...
September 2017: Case Reports in Gastroenterology
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