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Case Reports in Gastrointestinal Medicine

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https://www.readbyqxmd.com/read/27891266/a-silent-and-chronic-complication-of-percutaneous-endoscopic-gastrostomy-tube-small-bowel-enterocutaneous-fistula
#1
Sai Wah Cheung
Percutaneous endoscopic gastrostomy (PEG) has gradually gained the popularity since its invention and become the most preferred method for gastrostomy insertion in recent years. PEG is associated with lower morbidity and mortality and has the advantages of being minimally invasive and more convenient over the conventional open gastrostomy. However, significant rates of major complication still occur. Enterocutaneous fistula is one of the key complications that can be easily neglected due to its asymptomatic nature...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27891265/a-unique-case-of-pancreatic-mass-due-to-pancreatic-elastofibromatosis
#2
Abhinav Goyal, Deepanshu Jain, Ishfaq Bhat, Shailender Singh
Elastofibroma is a benign tumor of the musculoskeletal system characterized by the abnormal accumulation of elastinophilic fibers. It has been classically described for subscapular region but has been reported in several musculoskeletal sites over the years and rarely even in the GI tract but never in pancreas. We therefore present the case of a 45-year-old female who presented with intermittent abdominal pain. CT of abdomen revealed 1.4 cm pancreatic neck lesion without peripancreatic lymphadenopathy. Endoscopic ultrasound (EUS) guided FNA was nondiagnostic...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27885346/association-between-oesophageal-diverticula-and-leiomyomas-a-report-of-two-cases
#3
Muhammad Chowdhry, Christina Spyratou, Bruno Lorenzi, Sritharan Kadirkamanathan, Alexandros Charalabopoulos
We report two rare cases of female patients presenting with oesophageal leiomyoma associated with oesophageal diverticulum, both of whom were surgically managed. Oesophageal leiomyoma and oesophageal diverticulum are uncommon as separate entities and rare as combined disease presentation. Clinicians need to be aware of the rare combination of the two entities and need to be able to exclude the presence of a tumour (benign or malignant) within a diverticulum and so plan the optimum treatment. Herein, we present two cases of oesophageal leiomyoma within oesophageal diverticulum and we try to elucidate the association between the two...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27847657/rare-case-of-an-epithelial-cyst-in-an-intrapancreatic-accessory-spleen-treated-by-robot-assisted-spleen-preserving-distal-pancreatectomy
#4
Willemijn P M van Dijck, Vincent P Groot, Lodewijk A A Brosens, Jeroen Hagendoorn, Inne H M Borel Rinkes, Maarten S van Leeuwen, I Quintus Molenaar
Epithelial cyst in an intrapancreatic accessory spleen (ECIPAS) is exceedingly rare with only 57 cases reported since the first publication in 1980. Comprehensive clinical and diagnostic features remain to be clarified. We present a case of ECIPAS in a 21-year-old Philippine woman who was admitted with right upper quadrant abdominal pain. A cystic lesion in the pancreatic tail was discovered and evaluated by computed tomography and magnetic resonance images. Based on clinical and radiological features a solid pseudopapillary neoplasm was suspected...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27847656/an-unusual-suspect-lymphoepithelial-cyst-of-the-pancreas
#5
Abimbola Adike, Jennifer L Horsley-Silva, Neha Deval, Christopher R Conley, Dora M Lam-Himlin, Cuong C Nguyen
Lymphoepithelial cysts (LECs) of the pancreas are benign, rare pancreatic cysts that are found predominantly in men. These cysts can present as a diagnostic conundrum given their rarity and difficulty of distinguishing these cysts from those with malignant potential. We present an incidental case of a LEC in a middle-aged man.
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27843656/massive-upper-gastrointestinal-bleeding-caused-by-diffuse-large-b-cell-lymphoma
#6
O Telci Caklili, H H Mutlu, Y Colak, E Ozturk, D Kosemetin Dover, I Tuncer
Massive upper gastrointestinal bleeding is a life-threatening emergency which needs urgent intervention. Hematological malignancies are very rare causes of this type of bleeding and they usually originate from duodenum. In this case we present a gastric diffuse large B-cell lymphoma (DLBCL) causing massive upper gastrointestinal system bleeding. A 77-year-old male patient was admitted to emergency clinic with hematemesis and hematochezia. In physical examination patient was pale and sweaty; his vitals were unstable with a heart rate of 110 per minute and a blood pressure of 90/50 mmHg...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27830096/hemorrhage-from-extra-antral-gastric-antral-vascular-ectasia-in-a-patient-with-duodenal-heterotopic-gastric-mucosa
#7
John Gubatan, Nathan Raines, Hasan Khosravi, Tracy L Challies, Tyler M Berzin
Gastric antral vascular ectasias (GAVE) have been increasingly recognized as an uncommon cause of chronic gastrointestinal bleeding and anemia, although their underlying pathogenesis is not completely well understood. Heterotopic gastric mucosa (HGM) has been reported to occur at various sites along the gastrointestinal tract and although relatively common, it is often asymptomatic. We report a case of a 60-year-old woman with a prior history of GAVE who developed melena and symptomatic anemia during her hospitalization following cardiac catheterization...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27812393/primary-histoplasma-capsulatum-enterocolitis-mimicking-peptic-and-inflammatory-bowel-disease
#8
Rahman Nakshabendi, Andrew C Berry, Daisy Torres-Miranda, Francis Daniel LaBarbera, Ozdemir Kanar, Ahmad Nakshabandi, Imad Nakshabendi
In immunocompromised patients, histoplasmosis may present as disseminated disease. We present a 52-year-old Caucasian male with symptoms of dyspepsia, postprandial epigastric pain, nausea, and nonbloody diarrhea. Upper and lower gastrointestinal endoscopies were suspicious for inflammatory bowel disease (IBD); however, biopsies were consistent with histoplasmosis, specifically in the duodenum.
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27812392/periesophageal-pseudoaneurysms-rare-cause-of-refractory-bleeding-treated-with-transarterial-embolization
#9
Divyanshoo R Kohli, Rachit D Shah, Daniel J Komorowski, George B Smallfield
A 43-year-old female with history of systemic lupus erythematosus, prior cytomegalovirus esophagitis treated with ganciclovir, and long segment Barrett's esophagus (Prague class C8 M9) with high grade dysplasia treated with radiofrequency ablation presented to the hospital with hematemesis. An upper gastrointestinal endoscopy showed multiple esophageal ulcers with active arterial spurting which could not be controlled with endoscopic interventions including placement of hemostatic clips. An emergent angiogram demonstrated actively bleeding saccular dilations (pseudoaneurysms) in the esophageal branches of the lower thoracic aorta as well as left gastric artery for which gelfoam and coil embolization was initially successful...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27812391/use-of-aldosterone-antagonist-to-treat-diarrhea-and-hypokalemia-of-ogilvie-s-syndrome
#10
Pradhum Ram, Abhinav Goyal, Marvin Lu, Joshua Sloan, William McElhaugh
Ogilvie's syndrome (OS) is a functional obstruction of the bowel due to an autonomic imbalance. It often presents with diarrhea and is associated with hypokalemia. We present a case of a 70-year-old male who developed severe abdominal distension, watery diarrhea, and persistent hypokalemia status after left hip arthroplasty after suffering from a femoral neck fracture due to a fall and was diagnosed with OS. The persistent hypokalemia was slow to improve despite aggressive repletion because of the high potassium losses in the stool...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27803820/seronegative-intestinal-villous-atrophy-a-diagnostic-challenge
#11
Cláudio Martins, Cristina Teixeira, Suzane Ribeiro, Daniel Trabulo, Cláudia Cardoso, João Mangualde, Ricardo Freire, Ana Luísa Alves, Élia Gamito, Isabelle Cremers, Ana Paula Oliveira
Celiac disease is the most important cause of intestinal villous atrophy. Seronegative intestinal villous atrophy, including those that are nonresponsive to a gluten-free diet, is a diagnostic challenge. In these cases, before establishing the diagnosis of seronegative celiac disease, alternative etiologies of atrophic enteropathy should be considered. Recently, a new clinical entity responsible for seronegative villous atrophy was described-olmesartan-induced sprue-like enteropathy. Herein, we report two uncommon cases of atrophic enteropathy in patients with arterial hypertension under olmesartan, who presented with severe chronic diarrhea and significant involuntary weight loss...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27800195/an-unusual-case-of-gastrointestinal-bleeding-from-isolated-gallbladder-varices-in-a-patient-with-pancreatic-cancer-complicated-by-portal-biliopathy
#12
Mahir Gachabayov, Kubach Kubachev, Elbrus Abdullaev, Nonna Zarkua, Abakar Abdullaev, Artur Fokin
Portal biliopathy is the complex of abnormalities of extrahepatic and intrahepatic bile ducts, cystic duct, and gallbladder, arising as a result of extrahepatic portal vein obstruction and noncirrhotic portal fibrosis, which can be caused by coagulopathies, tumors, inflammation, postoperative complications, dehydration, and neonatal umbilical vein catheterization. We report a case of a 55-year-old male patient with the history of pancreatic cancer and cholecystoenteric anastomosis presenting with gastrointestinal bleeding from gallbladder varices via the anastomosis...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27781129/giant-inflammatory-fibroid-polyp-of-the-hepatic-flexure-of-colon-presenting-with-an-acute-abdomen
#13
Ashish Lal Shrestha, Pradita Shrestha
Background. Inflammatory Fibroid Polyp (IFP) of the colon is an exceedingly rare condition. Since 1952 till now only 32 cases have been reported worldwide of which only 5 were giant (>4 cm) polyps mostly found in the caecum (15 cases) with only 3 in the descending colon. Case Presentation. A 36-year-old female with no previous illness presented to the emergency unit with an acute onset pain over the right hypochondrium for 3 days associated with intermittent fever and anorexia. As she had evidence of localized peritonitis she underwent a diagnostic laparoscopy and subsequently an exploratory laparotomy...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27752370/barrett-s-oesophagus-in-an-achalasia-patient-immunological-analysis-and-comparison-with-a-group-of-achalasia-patients
#14
Samuel Torres-Landa, Janette Furuzawa-Carballeda, Enrique Coss-Adame, Miguel A Valdovinos, Edgar Alejandro-Medrano, Bárbara Ramos-Ávalos, Braulio Martínez-Benítez, Gonzalo Torres-Villalobos
The aim of the study was to characterize the presence of diverse CD4 and CD8 T cell subsets and regulatory cells in peripheral blood and lower oesophageal sphincter (LES) from a young patient with BE/achalasia without treatment versus achalasia group. In order to characterize the circulating cells in this patient, a cytometric analysis was performed. LES tissue was evaluated by double-immunostaining procedure. Five healthy blood donors, 5 type achalasia patients, and 5 oesophagus tissue samples (gastrooesophageal junction) from transplant donors were included as control groups...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27747112/laparoscopic-resection-of-pancreatic-tail-solid-pseudopapillary-tumour-in-a-young-male
#15
W G P Kanchana, R A A Shaminda, K B Galketiya, V Pinto, D Walisinghe, S Wijetunge, R Heendeniya
Background. Solid Pseudopapillary Tumours of the pancreas are a rare entity and more commonly seen in women than in men. These tumours have typically reached large sizes when clinically detected. Case Description. A 21-year-old male was found to have a left hypochondrial mass on physical examination following a trivial soft tissue injury. Contrast-enhanced computed topography (CT) of the abdomen showed a 10.3 × 7.6 × 10.3 cm size arising from the body and the tail of the pancreas. He underwent laparoscopic resection of distal pancreatic tumour en bloc with spleen...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27747111/magnifying-endoscopic-features-of-follicular-lymphoma-involving-the-stomach-a-report-of-two-cases
#16
Masaya Iwamuro, Katsuyoshi Takata, Seiji Kawano, Nobuharu Fujii, Yoshiro Kawahara, Tadashi Yoshino, Hiroyuki Okada
A 70-year-old woman presented with follicular lymphoma involving the stomach, duodenum, jejunum, bone, and lymph nodes. Esophagogastroduodenoscopy revealed multiple depressed lesions in the stomach. Examination with magnifying endoscopy showed branched abnormal vessels along with gastric pits, which were irregularly shaped but were preserved. The second case was a 45-year-old man diagnosed with stage II1 follicular lymphoma with duodenal, ileal, and colorectal involvement, as well as lymphadenopathy of the mesenteric lymph nodes...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27738535/pancreatic-neuroendocrine-tumor-in-the-setting-of-dorsal-agenesis-of-the-pancreas
#17
Samih Nassif, Cecilia Ponchiardi, Teviah Sachs
Dorsal agenesis of the pancreas (DAP) is an uncommon embryological abnormality where there is absence of the distal pancreas. DAP is mostly asymptomatic, but common presenting symptoms include diabetes mellitus, abdominal pain, pancreatitis, enlarged pancreatic head, and, in a few cases, polysplenia. MRCP and ERCP are the gold standard imaging techniques to demonstrate the absence of the dorsal pancreatic duct. The literature on the association of pancreatic neoplasia and DAP is limited. We present the case of a pancreatic neuroendocrine tumor in a patient with dorsal agenesis of the pancreas, with a review of the related literature...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27672459/an-atypical-presentation-of-sporadic-jejunal-burkitt-s-lymphoma
#18
Pratik Naik, James Wang, Michael J Brazeau, Domingo Rosario
Burkitt's lymphoma is a very aggressive type of B-cell NHL with replication approaching 100%. Primary gastrointestinal lymphoma is rare. In our case, a 24-year-old male initially presented with symptomatic anemia. He was initially evaluated with colonoscopy and EGD, both of which were unremarkable. A capsule endoscopy was then performed to further evaluate his significant anemia which revealed friable inflamed ulcerated mass in the jejunum. A push enteroscopy was then performed to obtain tissue from the jejunal mass...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27668102/a-unique-case-of-mycophenolate-induced-colitis-after-10-years-of-use
#19
Abhinav Goyal, Moiz Salahuddin, Yogesh Govil
A 31-year-old female with a history of lupus nephritis on Hydroxychloroquine, Prednisone, and Mycophenolate Mofetil (MMF) for 10 years presented to the hospital for ankle swelling. On day four, she started to have severe, nonbloody, watery diarrhea with abdominal distension and tenderness. Stool PCR was negative for C. difficile. CT abdomen/pelvis showed gaseous distension of the colon without any obstruction. Flexible sigmoidoscopy revealed a normal looking mucosa. Histopathology showed crypt atrophy and increased crypt apoptosis, consistent with MMF colitis...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27651962/listeria-rhombencephalitis-complicating-anti-tnf-treatment-during-an-acute-flare-of-crohn-s-colitis
#20
L Stratton, G R Caddy
Patients with Crohn's disease often require the use of immunosuppressant drugs to control disease activity. Such medication includes steroids, azathioprine, and biologic therapy. These suppress the immune response, and the patient is more susceptible to infection. We present a case of a 69-year-old gentleman with a history of Crohn's colitis who had ongoing symptoms of diarrhoea in spite of standard treatment. Biologic therapy was considered to be the next step, and screening for infection was undertaken prior to use...
2016: Case Reports in Gastrointestinal Medicine
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