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Case Reports in Gastrointestinal Medicine

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https://www.readbyqxmd.com/read/29785309/colopancreatic-fistula-an-uncommon-complication-of-recurrent-acute-pancreatitis
#1
Mouhanna Abu Ghanimeh, Omar Abughanimeh, Khalil Abuamr, Osama Yousef, Esmat Sadeddin
Colonic complications, including colopancreatic fistulas (CPFs), are uncommon after acute and chronic pancreatitis. However, they have been reported and are serious. CPFs are less likely to close spontaneously and are associated with a higher risk of complications. Therefore, more definitive treatment is required that includes surgical and endoscopic options. We present a case of a 62-year-old male patient with a history of heavy alcohol intake and recurrent acute pancreatitis who presented with a 6-month history of watery diarrhea and abdominal pain...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29732226/acute-gastrointestinal-bleeding-in-olmesartan-associated-collagenous-gastroduodenitis-a-potential-endoscopic-complication
#2
Rachel Hudacko, Lance Siegel
Collagenous gastroenteritis is a rare disease that is known to be associated with the drug olmesartan, an angiotensin II receptor antagonist used to treat hypertension. It is characterized histologically by increased subepithelial collagen deposition with associated inflammation and epithelial injury. Endoscopically, the mucosa appears inflamed and friable and may be nodular or atrophic. We report a case of acute gastric bleeding on direct mucosal contact during endoscopy in a patient with olmesartan-associated collagenous gastroduodenitis to raise awareness of this potential endoscopic complication...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29686910/cystic-lymphangioma-are-triglycerides-always-measurable
#3
Silke Fran├žois, Manuella Martin, Olivier Costa, Daniel Urbain, Fazia Mana
The presence of chylous fluid with high triglycerides levels on endoscopic ultrasound- (EUS-) guided fine needle aspiration (FNA) is very pathognomonic for the diagnosis of cystic lymphangiomas of the pancreas. In our case report the puncture of the pancreatic cyst showed a typical milky fluid though measurable triglyceride concentrations were absent in the laboratory. Two possible explanations were found. First of all grossly lipemic samples show a slower rate of color development than do clear serums which can produce a false negative result if the sample is insufficiently diluted...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29686909/spontaneous-bacterial-peritonitis-due-to-lactobacillus-paracasei-in-cirrhosis
#4
Emily Harding-Theobald, Bharat Maraj
Lactobacillus species colonize the human gastrointestinal tract and are rarely pathogenic. We present a case involving a cirrhotic patient who presented with sepsis and was found to have peritoneal cultures demonstrating Lactobacillus as the sole pathogen concerning for spontaneous bacterial peritonitis. Treatment was achieved with high-dose penicillin and clindamycin but the patient developed hepatorenal syndrome and died from acute renal failure. Intra-abdominal Lactobacillus infections are typically seen in patients undergoing peritoneal dialysis or who have recently had bowel perforation...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29682365/bedside-endoscopic-retrograde-cholangiopancreatography-using-portable-x-ray-in-acute-severe-cholangitis
#5
Rushikesh Shah, Emad Qayed
Patients with acute cholangitis require emergent biliary decompression. Those who are hemodynamically unstable on vasopressor support and mechanical ventilation are too critically ill to move outside of the intensive care unit. This prohibits performing Endoscopic Retrograde Cholangiopancreatography (ERCP) in the endoscopy unit. Fluoroscopic guidance is required to confirm deep biliary cannulation during ERCP. There are a few reported cases of bedside ERCP using portable C-arm fluoroscopy unit or ultrasound guided cannulation...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29682364/gastrointestinal-tuberculosis-presenting-as-malnutrition-and-distal-colonic-bowel-obstruction
#6
Raja Chandra Chakinala, Zahava C Farkas, Benjamin Barbash, Khwaja F Haq, Shantanu Solanki, Muhammad Ali Khan, Edward Esses, Taliya Farooq, Brad Dworkin
Gastrointestinal (GI) tuberculosis (TB) is rare and can occur in the context of active pulmonary disease or as a primary infection with no pulmonary symptoms. It typically presents with vague abdominal symptoms, making it difficult to discern from alternative disease processes. Although the ileocecal region is the most commonly affected site, tuberculous enteritis can involve any aspect of the GI tract. To demonstrate the importance of maintaining a high clinical suspicion for the disease, we present a case of GI TB presenting as severe malnutrition and segmental colitis of the left colon...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29670775/mesenteric-panniculitis-presenting-as-fever-of-unknown-etiology-in-a-patient-with-history-of-abdominal-surgery
#7
Christopher P Irwin, Joo B Lee, Andrew Kim, Ijagha Eme, Christina Schofield, George Mount
Mesenteric panniculitis is characterized by nonspecific fibrous inflammation of the small bowel mesentery, appendix, and mesoappendix. Clinical course is usually benign and outcome is favorable. We report a case of mesenteric panniculitis presenting as fever of unknown etiology in a patient with history of abdominal surgery.
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29666723/a-challenging-case-of-severe-ulcerative-colitis-following-the-initiation-of-secukinumab-for-ankylosing-spondylitis
#8
Dean Ehrlich, Nimah Jamaluddin, Joseph Pisegna, David Padua
Secukinumab is an interleukin-17 inhibitor used for the treatment of ankylosing spondylitis (AS), psoriasis, and psoriatic arthritis. The risk of exacerbating underlying inflammatory bowel disease (IBD) in patients being treated with secukinumab for other conditions is controversial. We document a patient with AS and previously undiagnosed IBD, found to be in a severe ulcerative colitis flare shortly after receiving the loading dose of secukinumab. There are no guidelines regarding biologic salvage therapy for IBD in the setting of active treatment with another biologic agent...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29666722/postmenopausal-deep-infiltrating-endometriosis-of-the-colon-rare-location-and-novel-medical-therapy
#9
Benjamin M Snyder, Joseph W Beets, Bruce A Lessey, Samuel R W Horton, Gary A Abrams
We report an uncommon case of deep infiltrating endometriosis of the colon presenting as iron deficiency anemia nine years after hysterectomy with bilateral salpingo-oophorectomy. The endometrial implant was found at the hepatic flexure, an exceedingly rare location for endometriosis invasion with no cases distinctly reported in the literature. Additionally, the presentation of gastrointestinal endometriosis as iron deficiency anemia is not well documented in the literature. Instead of surgery, we prescribed a novel medical therapeutic approach using conjugated estrogen-bazedoxifene to antagonize the proliferative effects of estrogen on endometrial tissue...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29666721/needle-knife-fistulotomy-for-the-rescue-an-unusual-cause-of-iatrogenic-extrahepatic-biliary-obstruction
#10
Laura L Ulmer, Lokesh K Jha, Neil Bhogal, Saurabh Kapur, Saurabh Chandan, Derrick Eichele, Ishfaq Bhat, Shailender Singh
A 71-year-old male presented to our institution with cholestatic hepatitis after having recently undergone upper endoscopy for treatment of gastrointestinal bleeding. Further investigation with endoscopic retrograde cholangiopancreatography revealed a hemostatic clip on the ampulla of Vater. After initial attempts at cannulation of the common bile duct were unsuccessful, biliary decompression was achieved by use of needle-knife fistulotomy. A common bile duct stent was placed and the liver function tests improved prior to discharge...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29666720/gastric-malt-lymphoma-with-increased-plasma-cell-differentiation-showing-unique-endoscopic-features
#11
Masaya Iwamuro, Takehiro Tanaka, Kenji Nishida, Seiji Kawano, Yoshiro Kawahara, Shogen Ohya, Tadashi Yoshino, Hiroyuki Okada
A 62-year-old woman was diagnosed with extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) with increased plasma cell differentiation of the stomach. Esophagogastroduodenoscopy showed slightly elevated, whitish lesions in the gastric body. Magnifying endoscopic observation revealed that the gastric surface epithelium was swollen, but the structure was not destroyed or diminished. Elongated, tortuous vasculature was observed on the surface of the whitish lesions. The patient underwent eradication treatment for Helicobacter pylori , which resulted in complete remission...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29666719/endoscopic-treatment-of-colonic-duplication-cyst-a-case-report-and-review-of-the-literature
#12
Rajat Garg, Louis D Saravolatz, Mohammed Barawi
Colonic duplication cysts are a rare congenital abnormality commonly presenting before two years of age. In adults, it has been rarely reported, most often as an incidental finding. We report a case of 42-year-old female complaining of constipation and lower abdominal pain. Patient's CT scan of the abdomen showed a cystic lesion at hepatic flexure and the diagnosis was confirmed endoscopically using endoscopic ultrasound (EUS). The cyst was treated employing hot snare to expose the cyst cavity. On our literature search, there have been no reported cases of colonic duplication cyst treated endoscopically...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29666718/an-autopsy-case-of-misdiagnosed-wernicke-s-syndrome-after-intragastric-balloon-therapy
#13
Paola Vellante, Aldo Carnevale, Cristian D'Ovidio
Intragastric balloon (IGB) therapy is a widely used technique to counter obesity, and it is known to be safe and effective. Although there can be a high rate of side effects following IGB therapy, most are self-healing and they are mainly accommodative in nature. Few cases of Wernicke's syndrome under IGB therapy have been described in the literature, and to the best of our knowledge, none have been fatal. We present here a case of a 51-year-old woman who underwent IGB therapy over 8 months. Late diagnosed Wernicke's syndrome that first appeared as lower limb neuropathy progressively immobilized the patient, until she required bed rest...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29623225/ischemic-colitis-in-sickle-cell-disease-a-case-report-of-a-diagnostic-challenge
#14
Kyle Geary, Jacob Kibrit
Microvascular occlusion serves as the underlying mechanism for the multitude of clinical manifestations of sickle cell disease, one of the most prevalent hemoglobinopathies worldwide. Recurrent painful episodes are the hallmark of this condition. Abdominal pain attributed to an acute painful episode can be indistinguishable from a separate and/or more serious intra-abdominal disease process, representing a significant diagnostic dilemma for clinicians. Here we present a rare case of ischemic colitis due to vascular occlusion in a 28-year-old man with sickle cell disease...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29593917/a-case-of-unresolved-and-worsening-retroperitoneal-abscess
#15
Raghav Bansal, Mohamed Barakat, Soohwan Chun, Sonam Rosberger, Joel Baum, Melik Tiba
Retroperitoneal abscess is a rare condition which is difficult to diagnose and treat because of its insidious onset. Herein, we present a case of retroperitoneal abscess secondary to a perforation that occurred during an ERCP. A 54-year-old female patient was admitted to an outside hospital with gallstone pancreatitis and underwent ERCP with sphincterotomy followed by laparoscopic cholecystectomy. An abdominal CT scan was performed at the outside hospital 10 days later for worsening abdominal pain which showed multiple loculated pockets in the right upper and lower quadrant...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29593916/primary-pancreatic-burkitt-s-lymphoma-a-case-report-and-review-of-the-literature
#16
Venkata Rajesh Konjeti, Gerald M Hefferman, Sravanthi Paluri, Prerna Ganjoo
Primary pancreatic lymphoma (PPL) is of very rare occurrence as an extra nodal site of Non-Hodgkin's lymphoma (NHL). It represents less than 1% of NHL. Out of which Burkitt lymphoma of pancreas is of a rare presentation. It usually occurs in children and presenting in adults is uncommon. The prevalence of pancreatic Burkitt lymphoma is not known as the incidence is significantly low. Clinical features of PPL are predominantly nonspecific and can become difficult with associated inflammation of pancreas. Differentiation of lymphoma to adenocarcinoma is important as chemotherapy is the main stay of treatment in lymphoma...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29593915/surgery-to-treat-symptomatic-mobile-cecum-syndrome-is-safe-and-associated-with-good-recovery-outcomes
#17
Manuela Cesaretti, Manuela Trotta, Irene Leale, Giuseppe Antonio Minetti, Giuseppe Cittadini, Fabrizio Montecucco, Giovanni Bruno Camerini, Giacomo Borgonovo
The mobile cecum syndrome includes a spectrum of conditions. The cecal volvulus represents the acute form, with typical feature of a bowel obstruction that needs immediate operative treatment. On the other hand, a chronic form of mobile cecum syndrome which is the most common form reported a history of intermittent crampy abdominal pain, distension, and constipation. In this study, five patients came to our attention during the last ten years, presenting different symptoms due to a mobile cecum. All patients were investigated by several diagnostic techniques according to the specific clinical setting...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29552363/a-severe-case-of-ipilimumab-induced-ileocolitis-refractory-to-glucocorticosteroids-and-infliximab
#18
Behdod Poushanchi, Hiren Vallabh, Gorman Joel Reynolds
Ipilimumab is a monoclonal antibody that works as an immunotherapeutic agent through selective targeting of T cells to strengthen the response to metastatic melanoma. It is well known that this pharmaceutical agent can cause the adverse effect of colitis. We report a rare presentation of ileocolitis refractory to both glucocorticosteroids and infliximab with a resultant pneumatosis and perforation requiring subtotal colectomy and end ileostomy.
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29435376/a-rare-encounter-with-an-expanding-pseudocyst-of-the-spleen
#19
Ashish Lal Shrestha, Pradita Shrestha
Background: Splenic Pseudocyst (SP) is a diagnostic rarity, with cystic lesions of spleen themselves being uncommon. Establishing a preoperative diagnosis could help in specific management but this is rather challenging. Here we present a common presentation of an uncommon diagnosis. Case Presentation: A 47-year-old lady, previously well, presented to the outpatient clinic with intermittent left hypochondrial pain radiating towards left shoulder for 2 months not associated with fever, jaundice, or weight loss...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29435375/hydrogen-peroxide-induced-colitis-a-case-report-and-literature-review
#20
Dushyant Pawar, Anna Calara, Roy Jacob, Nancy Beck, Alan N Peiris
Constipation is a common condition. Hydrogen peroxide enemas have rarely been reported as a home remedy for constipation in the pediatric age group. We present a case report and literature review of hydrogen peroxide induced colitis in pediatric siblings, aged 2 years and 9 years. The siblings presented with vomiting and bloody diarrhea an hour following the enema. Physical exam, vital signs, blood, and electrolyte counts were normal, but CT scans showed mucosal thickening of the rectum and colon. Their symptoms resolved after oral intake was curtailed and fluids were replaced intravenously...
2017: Case Reports in Gastrointestinal Medicine
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