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Case Reports in Gastroenterology

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https://www.readbyqxmd.com/read/29282391/multifocal-mass-lesions-in-autoimmune-pancreatitis
#1
Kazuhiro Suzumura, Etsuro Hatano, Naoki Uyama, Toshihiro Okada, Yasukane Asano, Seikan Hai, Keiji Nakasho, Jiro Fujimoto
A 59-year-old male patient with jaundice was referred to our hospital because of mass lesions in the pancreatic head and tail. An immunological examination revealed an elevated serum IgG4 level. Computed tomography showed two clear boundary mass lesions in the pancreatic head and tail. Magnetic resonance imaging showed that the mass lesions exhibited low intensity on T1-weighted images and iso-intensity on T2-weighted images. Magnetic resonance cholangiopancreatography showed an obstruction of the main pancreatic duct in the pancreatic head and tail...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29282390/autoimmune-hepatitis-a-risk-factor-for-cholangiocarcinoma
#2
Rajat Garg, Uqba Khan, Ahmed AlRajjal, Zyad Kafri
Cholangiocarcinoma (CCA) is a very aggressive and lethal tumor, which arises from the epithelial cells of bile ducts. CCA comprises about 3% of all gastrointestinal malignancies and its incidence is on the rise in the recent years. Anatomically, it is classified into intrahepatic, perihilar, or extrahepatic (distal) CCA. There are a number of risk factors associated with CCA including primary sclerosing cholangitis, fibropolycystic liver disease, parasitic infection, viral hepatitis, chronic liver disease, and genetic disorders like Lynch syndrome...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29282389/listeria-monocytogenes-brain-abscess-in-crohn-s-disease-treated-with-adalimumab
#3
Amporn Atsawarungruangkit, Fernando Dominguez, Gustavo Borda, Nikolaos Mavrogiorgos
Listeria monocytogenes is a gram-positive bacterium that causes listeriosis. Brain abscess is a very uncommon manifestation of listeriosis and has not been reported to be associated with adalimumab (humira), one of the approved medications for treating Crohn's disease. A 45-year-old female with Crohn's disease presented with sudden onset of fever, headache, nausea, vomiting, and altered mental status for 1 day. She was on prednisone and 6-mercaptopurine. She had started taking adalimumab 17 days prior to admission...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29282388/a-rare-case-of-intraductal-tubulopapillary-neoplasm-of-the-pancreas-rupturing-and-causing-acute-peritonitis
#4
Akira Umemura, Kazuyuki Ishida, Hiroyuki Nitta, Takeshi Takahara, Yasushi Hasegawa, Kenji Makabe, Akira Sasaki
An intraductal tubulopapillary neoplasm (ITPN) is a very rare pancreatic tumor. Here we report an extremely rare case of an ITPN rupturing and causing acute peritonitis. A 50-year-old woman presented with left flank pain and vomiting. A computed tomography (CT) scan revealed gigantic multilocular cysts in the pancreatic tail and massive fluid collection in the abdominal cavity. The serum, urine, and abdominal fluid amylase levels were highly elevated, so she was conservatively treated with intraperitoneal drainage and antibiotics for a diagnosis of ruptured pancreatic cysts...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29282387/gastric-adenocarcinoma-with-dual-differentiation-toward-neuroendocrine-and-%C3%AE-fetoprotein-producing-features-report-of-2-cases
#5
Shun Iida, Shinichi Ban, Keizo Kato, Shinji Endo, Ryota Matsuo, Kosuke Hirano, Takashi Okuyama, Yukinori Yamagata, Yoshihiko Ueda
Some gastric carcinomas show composite features of neuroendocrine carcinoma (NEC) and α-fetoprotein (AFP)-producing carcinoma, which are very rare; only a few cases have been reported to date. We reviewed an additional 2 such cases of gastric carcinoma, which were both advanced aggressive tumors showing regional lymph node metastasis and distant metastasis. Both cases were accompanied by ordinary adenocarcinoma forms, implying that they had preceded the NEC and AFP-producing carcinoma components. A distinctive feature was the finding suggestive of dual differentiation of tumor cells to neuroendocrine and AFP-producing phenotypes, which was identified even in the metastatic tumor in the regional lymph node...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29282386/microvillus-inclusion-disease-variant-in-an-infant-with-intractable-diarrhea
#6
Badr M Rasheed Alsaleem, Amna Basheer M Ahmed, Musa Ahmad Fageeh
Microvillus inclusion disease (MVID) is a rare autosomal recessive congenital enteropathy characterized by intractable secretory diarrhea. We report a case of MVID variant with a homozygous gene mutation in syntaxin 3 (STX3). The patient is a male Saudi infant who presented shortly after birth with severe vomiting, metabolic acidosis, and mild diarrhea. Electron microscopy study for small intestinal biopsy was consistent with MVID. MYO5B gene mutation was excluded; subsequently, whole exome sequencing (WES) was performed, which revealed homozygous gene mutation in STX3...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29282385/internal-hernia-into-the-treitz-fossa-after-pancreaticoduodenectomy
#7
Takahiro Yamanaka, Kenichiro Araki, Kei Hagiwara, Norihiro Ishii, Mariko Tsukagoshi, Takamichi Igarashi, Akira Watanabe, Norio Kubo, Hiroyuki Kuwano, Ken Shirabe
The development of an internal hernia into the Treitz fossa after pancreaticoduodenectomy has not been previously reported. We herein present such a case with a brief review of the literature. A 43-year-old man who had undergone pancreaticoduodenectomy with reconstruction of the digestive tract by the Child method at our hospital 7 months previously presented with abdominal pain. Computed tomography showed intestinal ileus with formation of a small intestinal loop that was suspected to be an internal hernia...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29282384/hepatocyte-nuclear-factor-1%C3%AE-mutated-hepatocellular-adenomas-an-atypical-presentation
#8
Camila Maria Neves Sousa, Patricia Maria Miranda Gadelha, Rafaella de Sousa Cartaxo, George Washington Holanda Pedrosa, Rodrigo Schuler Honorio, José Milton de Castro Lima, Gustavo Rêgo Coelho, Clovis Rêgo Coelho
Hepatocellular adenomas (HCAs) are rare benign monoclonal hepatic tumors that commonly occur in females (3-4 per 100,000 women) due to the use of oral contraceptives, its primary risk factor. Recently, HCAs have been classified into 4 distinct subtypes according to genotypic and phenotypic characteristics and clinical features: inflammatory HCA (40-50%), which are hypervascular with marked peliosis and a tendency to bleed; hepatocyte nuclear factor 1α (HNF1A)-mutated HCA (H-HCA, 30-40%) that are diffusely steatotic and rarely undergo malignant transformation; β-catenin activated HCA (10-15%), which frequently undergo malignant transformation and may seem hepatocellular carcinoma on imaging; and unclassified HCA (10-25%)...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29282383/intussusception-due-to-an-inverted-meckel-s-diverticulum-diagnosed-by-double-balloon-enteroscopy
#9
Yuki Kawasaki, Satoshi Shinozaki, Tomonori Yano, Kenichi Oshiro, Mitsuaki Morimoto, Alan Kawarai Lefor, Hironori Yamamoto
An 18-year-old man presented after undergoing multiple investigations for abdominal pain. Retrograde double-balloon enteroscopy showed a protruding red lesion in the ileum with small ulcers, approximately 75 cm proximal to the ileocecal valve, resulting in an intussusception. An inverted Meckel's diverticulum was strongly suspected. Pressure was applied to the protruding lesion using contrast medium injection after wedging the lumen with a balloon. The intussusception partially reduced, avoiding the need for emergent surgery...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29282382/massive-upper-and-lower-gi-bleed-from-simultaneous-primary-al-amyloidosis-of-the-stomach-and-transverse-colon-in-a-patient-with-multiple-myeloma
#10
Zubair Khan, Umar Darr, Anas Renno, Abhinav Tiwari, Aijaz Sofi, Ali Nawras
Symptomatic primary (amyloid light-chain or AL) amyloidosis of the gastrointestinal (GI) tract is very rare. Most of the patients with symptomatic involvement of the GI tract present with altered motility, malabsorption, or bleeding. We report a case of gastric and colonic amyloidosis on anticoagulation presenting with massive upper and lower GI bleeding. A 67-year-old lady known to have multiple myeloma and AL amyloidosis on rivaroxaban presented with massive upper GI bleeding. Esophagogastroduodenoscopy showed a mass lesion (3 × 7 cm) located along the greater curvature in the body/antrum with active bleeding...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29282381/a-silent-asymptomatic-solid-pancreas-tumor-in-a-nonsmoking-athletic-female-pancreatic-ductal-adenocarcinoma
#11
Kyawzaw Lin, Aung Naing Lin, Sithu Lin, Thinzar Lin, Ying Xian Liu, Madhavi Reddy
A silent solid endocrine tumor of pancreas, intraductal adenocarcinoma of pancreas, is the fourth leading cancer-related death in the US. However, it is expected to become the third leading cause by 2030 owing to delayed diagnosis and slow progress in management. Chronic pancreatitis is at risk for pancreatic ductal adenocarcinoma (PDAC). PDAC is diagnostic with transabdominal sonogram, blood test such as carbohydrate antigen 19-9 (CA 19-9), and imaging. PDAC has a dismal prognosis. The survival rate in 5 years is barely 6%, while late detection rate is 80-85% with unresectable stage upon diagnosis...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29118691/vanishing-tumor-in-a-liver-graft-from-a-hepatitis-b-virus-surface-antigen-positive-donor
#12
Mayo Fuchino, Kazuto Tajiri, Masami Minemura, Toshiro Sugiyama
We report a case of vanishing tumor considered as inflammatory pseudotumor (IPT) found in the liver after living donor liver transplantation (LDLT) from a hepatitis B virus surface antigen-positive donor. The radiological findings were similar to those of hepatocellular carcinoma (HCC). However, the tumor disappeared completely within several months and was suggested to have been an IPT. IPT is known to be associated with biliary duct operation or biliary infection, and it can show various enhancement patterns in radiological studies, sometimes resembling HCC...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29118690/pneumoperitoneum-after-endoscopic-retrograde-cholangiopancreatography-due-to-rupture-of-intrahepatic-bile-ducts-and-glisson-s-capsule-in-hepatic-metastasis-a-case-report-and-review-of-literature
#13
Zubair Khan, Umar Darr, Mohamad Nawras, Muhammad Bawany, Jacob Bieszczad, Osama Alaradi, Ali Nawras
Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) has been proven to be a safe and effective method for diagnosis and treatment of biliary and pancreatic disorders. Major complications of ERCP include pancreatitis, hemorrhage, cholangitis, and duodenal perforation. We report a third case in literature of pneumoperitoneum after ERCP due to rupture of intrahepatic bile ducts and Glisson's capsule in a peripheral hepatic lesion. Case Report: A 50-year-old male with a history of metastatic pancreatic neuroendocrine tumor and who had a partially covered metallic stent placed in the biliary tree 1 year ago presented to the oncology clinic with fatigue, abdominal pain, and hypotension...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29118689/postpolypectomy-intramural-colonic-hematoma-the-conservative-management-of-a-potentially-fatal-complication
#14
Ravinder Mankoo, Vanessa Kuwajima
Most medical professionals consider colonoscopy to be a safe procedure with a low rate of severe complications such as bowel perforation, gastrointestinal tract bleeding, or mortality. Bowel wall hematoma is a rare complication associated with colonoscopy that can result in significant morbidity and even mortality. We present a case of postpolypectomy hematoma diagnosed with CT imaging and successfully managed in a conservative fashion.
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29118688/a-tale-of-two-lymphomas
#15
Vikrant Parihar, Paul Crotty, Deidre McNamara
We present a patient with coeliac disease who developed refractory coeliac disease II, which was complicated by the development of metachronous lymphomas.
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29118687/renoportal-anastomosis-in-left-lateral-lobe-living-donor-liver-transplantation-a-pediatric-case
#16
Hiroyuki Ogasawara, Chikashi Nakanishi, Shigehito Miyagi, Kazuaki Tokodai, Yasuyuki Hara, Wataru Nakanishi, Koji Miyazawa, Kenji Shimizu, Hiroyuki Kumata, Hitoshi Goto, Masafumi Goto, Michiaki Unno, Takashi Kamei
In adult liver transplantation, renoportal anastomosis (RPA) has been introduced as a useful technique for patients with grade 4 portal vein thrombosis and a splenorenal shunt. Here, we report a pediatric case in which RPA allowed a left lateral lobe living donor liver transplantation (LDLT) despite portal vein thrombosis and a large splenorenal shunt. At 36 days old, the patient underwent a Kasai operation for biliary atresia. At 17 months old, she underwent LDLT because of repetitive cholangitis. Pretransplant examinations revealed a large splenorenal shunt and portal vein thrombosis...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29118686/hepatectomy-for-hilar-cholangiocarcinoma-with-right-sided-ligamentum-teres-using-a-hepatectomy-simulation-system
#17
Seikan Hai, Etsuro Hatano, Tadamichi Hirano, Yasukane Asano, Kazuhiro Suzumura, Hideaki Sueoka, Jiro Fujimoto
Right-sided ligamentum teres (RSLT) is a rare congenital anomaly often accompanied by variation of the hepatic vasculature. We herein report a surgical case of a hilar cholangiocarcinoma with RSLT in whom preoperative hepatectomy simulation proved useful for understanding the anatomical structure of the liver. A 78-year-old male with obstructive jaundice was referred to our department for further examination. The patient was suspected of having a hilar cholangiocarcinoma originating from the left hepatic bile duct by contrast-enhanced computed tomography (CT), and CT also showed right umbilical portion (RUP)...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29118685/a-rare-thermophilic-bug-in-complicated-diverticular-abscess
#18
Kyawzaw Lin, Sithu Lin, Aung Naing Lin, Thinzar Lin, Zin Mar Htun, Madhavi Reddy
Actinomycosis is a form of painful abscess in the gastrointestinal tract or in deep tissue caused by actinomyces species. They are one of the commensal bacteria in the oral cavity and gastrointestinal tract of humans but can opportunistically cause infection in immunosuppressive hosts through invasion of breached mucosa or necrotic tissue while mimicking malignancy, gastrointestinal tuberculosis, and inflammatory bowel disease. Actinomyces israelii is, by far, the major and most common human pathogen throughout literatures...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29033779/a-patient-with-nafcillin-associated-drug-induced-liver-failure
#19
Qin Rao, Isaiah Schuster, Talal Seoud, Kevin Zarrabi, Nirvani Goolsarran
Nafcillin-induced acute liver injury is a rare and potentially fatal complication that has been known since the 1960s but inadequately studied. At this time, the only proven treatment is early discontinuation of the drug. Because of the high prevalence of nafcillin class antibiotic use in the United States, it is important for clinicians to have a high clinical suspicion for this diagnosis. We present a case of liver failure attributable to nafcillin use in a 68-year-old male with a history methicillin-sensitive Staphylococcus and L3/L4 osteomyelitis...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29033778/a-case-of-basaloid-squamous-cell-carcinoma-of-polypoid-type-in-the-esophagus
#20
Ki Hun Lee, Sang Jin Lee, Hak Soo Kim, Sung Eun Kim, Soo Yong Choi, Hyun Ju Lee, Suk Hun Ha, Kwang Hoon Oh, Dae-Woon Eom
Basaloid squamous cell carcinoma of the esophagus is very rare. Further, polypoid type of esophageal cancer is also rare. We have recently treated a case of basaloid squamous cell carcinoma which presented as a 1.3-cm esophageal polyp. A 48-year-old woman was referred to our hospital because of a polypoid mass at 36 cm distance from the upper incisor on endoscopic examination, and the result of the biopsy was basaloid squamous cell carcinoma. The patient underwent Ivor Lewis operation with lymph node dissection...
September 2017: Case Reports in Gastroenterology
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