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Case Reports in Gastrointestinal Medicine

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https://www.readbyqxmd.com/read/28529809/aberrant-pancreatic-tissue-in-a-mediastinal-enteric-duplication-cyst-a-rarity-with-review-of-literature
#1
Meha Mansi, Nidhi Mahajan, Sonam Mahana, C R Gupta, Anup Mohta
Mediastinal enteric duplication cysts are a rare congenital malformation encountered mainly in neonates and infants. It is a distinct entity within the family of foregut duplication cysts. It can present with respiratory distress due to mass effect and hence surgical excision is the preferred treatment. Histologically, it is characterised by a double layered smooth muscle wall with intestinal lining epithelium. We report a case of mediastinal enteric duplication cyst with aberrant pancreatic tissue in a neonate due to its rarity and early presentation...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28529808/mirrizi-syndrome-and-markedly-elevated-levels-of-carbohydrate-antigen-19-9-in-the-absence-of-malignant-disease
#2
Natasha Shah, Eula Tetangco, Hafiz Muhammad Sharjeel Arshad, Hareth Raddawi
Elevated carbohydrate antigen 19-9 (CA19-9) beyond 1000 U/L occurs in nonneoplastic conditions which is causing questioning of the use of CA19-9 as a marker for screening. We report a case where a 51-year-old male with Mirrizi Syndrome (MS) presented with markedly increased CA19-9 level (4,618 U/mL). MS is a rare complication characterized by compression of the common bile or hepatic duct caused by an impacted gallstone in the cystic duct or neck of the gallbladder. Biliary epithelial cells secrete CA19-9: it is hypothesized that increased proliferation of such cells caused by inflammation leads to increased secretion...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28512587/adenocarcinoma-in-situ-arising-from-brunner-s-gland-treated-by-endoscopic-mucosal-resection
#3
Masaya Iwamuro, Sayo Kobayashi, Nobuya Ohara, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada
An 86-year-old Japanese man was presented to our hospital for further investigation of duodenal adenocarcinoma. The tumor was endoscopically resected. Pathological analysis revealed coexistence of gastric foveolar metaplasia and a surrounding hyperplastic Brunner's gland, in addition to an adenocarcinoma component. Immunostaining for MUC5AC and MUC6 confirmed the diagnosis of adenocarcinoma in situ arising from Brunner's gland hyperplasia. This case suggests that although detailed preoperative evaluation is required to determine the depth of tumor invasion, endoscopic resection may be a promising option for the treatment of adenocarcinomas arising from Brunner's gland hyperplasia...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28487783/delayed-awareness-of-the-history-of-barium-examination-perforated-barium-appendicitis
#4
Susumu Saigusa, Masaki Ohi, Satoshi Oki, Takashi Ichikawa, Minako Kobayashi, Yasuhiro Inoue, Chikao Miki
A 41-year-old man presented to our hospital with lower abdominal pain and a high-grade fever. Physical examination revealed rebound tenderness and guarding in the lower abdomen. Abdominal X-ray examination showed a radiopaque object in the right lower quadrant of the abdomen. Abdominal computed tomography (CT) demonstrated that the object had a strong artifact with over 10,000 Hounsfield units, as well as ascites around the terminal ileum. We diagnosed acute peritonitis with a suspicion of the perforation due to unknown foreign body and performed an emergency laparotomy...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28487782/nodular-esophageal-xanthoma-a-case-report-and-review-of-the-literature
#5
Ahmed Dirweesh, Muhammad Khan, Sumera Bukhari, Cheryl Rimmer, Robert Shmuts
Xanthomas are localized nonneoplastic lesions within tissues that may manifest as papules, plaques, or nodules. These lesions can be found anywhere along the gastrointestinal tract, commonly in the stomach and colon, and rarely in the small intestine and esophagus. Esophagogastroduodenoscopy (EGD) with biopsy is the gold standard tool for diagnosis. Here, we report a rare case of a lower solitary nodular esophageal xanthoma in an elderly black female. Correspondingly, all cases of esophageal xanthomas reported in the English medical literature were reviewed and presented with the reported case...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28473931/hematochezia-an-uncommon-presentation-of-colonic-tuberculosis
#6
Fares Ayoub, Vikas Khullar, Harry Powers, Angela Pham, Shehla Islam, Amitabh Suman
Abdominal tuberculosis (TB) is an uncommon entity in the United States. Colonic TB is reported in 2-3% of patients with abdominal TB. It is frequently misdiagnosed as Crohn's disease or carcinoma of the colon due to their shared clinical, radiographic, and endoscopic presentations. We present a case of a 72-year-old male with colonic tuberculosis presenting as hematochezia. Our patient presented with shortness of breath and weight loss. Chest X-ray demonstrated ill-defined bilateral parenchymal opacities in the perihilar, mid, and lower lung zones...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28421150/post-ercp-emphysematous-cholecystitis-in-a-young-woman-a-rare-and-potentially-fatal-complication
#7
Roisin Stack, Joseph McLoughlin, Amy Gillis, Barbara M Ryan
A 45-year-old woman with suspected Functional Biliary Sphincter Disorder (FBSD) developed Clostridium perfringens related emphysematous cholecystitis after ERCP. A low index of suspicion for emphysematous cholecystitis in this young, otherwise healthy woman led to a significant delay in making the correct diagnosis, and air in the gallbladder was wrongly attributed to a possible gallbladder perforation. ERCP is associated with significant risks, particularly in patients with FBSD, where diagnostic uncertainty renders the balance of risk versus benefit even more critical...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28386490/an-uncommon-cause-of-a-small-bowel-obstruction
#8
Ali Zakaria, Bayan Al Share, Issam Turk, Samira Ahsan, Waseem Farra
Sarcoidosis is a systemic granulomatous disease of unknown etiology, characterized by the formation of noncaseating granulomas. Gastrointestinal (GI) system involvement that is clinically recognizable occurs in less than 0.9% of patients with sarcoidosis, with data revealing small intestine involvement in 0.03% of the cases. A high index of suspension is required in patients presenting with small-bowel obstruction and previous history of sarcoidosis. Establishing a definitive diagnosis of GI sarcoidosis depends on biopsy evidence of noncaseating granulomas, exclusion of other causes of granulomatous disease, and evidence of sarcoidosis in at least one other organ system...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28367340/postural-syncope-and-constipation-an-unusual-presentation-of-a-duodenal-dieulafoy-s-lesion
#9
Ahmed Dirweesh, Alvarez Chikezie, Muhammad Yasir Khan, Sana Zia, Muhammad Tahir
Dieulafoy lesions are a rare etiology of gastrointestinal bleeding from a large caliber-persistent tortuous submucosal artery. They account for 1-2% of all causes of acute gastrointestinal hemorrhage with 80%-95% of these lesions located in the stomach along the lesser curvature. One-third of these lesions present at an extragastric location, with the proximal duodenum accounting for 15% of them. We present a 21-year-old male with no significant past medical history or risk factors, who presented with repeated syncopal episodes followed by hematemesis, found to have a Dieulafoy lesion located at the duodenal bulb...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28357144/-black-esophagus-or-gurvits-syndrome-a-rare-complication-of-diabetic-ketoacidosis
#10
Vivek Choksi, Kairavee Dave, Rulz Cantave, Sameer Shaharyar, Jeevan Joseph, Uday Shankar, Steven Kaplan, Hamid Feiz
Acute esophageal necrosis (AEN) also known as "black esophagus" or necrotizing esophagitis is a rare syndrome characterized by a striking diffuse patchy or circumferential black appearance of the esophageal mucosa that preferentially affects the distal esophagus and terminates at the gastroesophageal junction. Only 88 patients over a span of 40 years have received this diagnosis, and the prevalence of this disease ranges from 0.001 to 0.2% of cases in literature. It more commonly affects men (4 : 1 ratio) in the sixth decade of life...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28331640/a-case-of-hepatic-portal-venous-gas-hypothesis-of-a-transient-direct-communication-between-a-penetrating-antral-gastric-ulcer-and-mesenteric-varices
#11
Hassan M Ghoz, Shamlan M Sheikh, Kanika Khandelwal, Joseph Fiore, Nicholas James, Joel Weinstock
Hepatic portal venous gas (HPVG) is a rare radiological sign that usually signifies an acute intra-abdominal process, most commonly bowel ischemia and sepsis. Few reports described an association with underlying gastric pathologies. We report a 60-year-old patient who presented with melena and chills and was discovered to have a gastric ulcer that appeared to have penetrated into a mesenteric varix. This, in turn, likely caused development of HPVG associated with fungemia. Treatment with a proton pump inhibitor and bowel rest was sufficient to resolve symptoms and the HPVG...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28326206/chronic-hepatitis-with-liver-granulomas-in-a-patient-with-granuloma-annulare-a-case-report-and-review-of-the-literature
#12
Majid Alsahafi, Mohammed I AlJasser, Sunil Kalia, H M Yang, Alnoor Ramji
Granuloma annulare (GA) is a benign granulomatous skin disorder of unknown etiology. GA is rarely associated with liver diseases. We report a unique case of chronic hepatitis with liver granulomas in a patient with GA. Despite an extensive workup, no clear etiology for the hepatitis was found. Based on the possible immune pathophysiology of GA and the presence of liver granulomas, the patient was treated with prednisone and azathioprine which resulted in complete normalization of the liver enzymes and concurrent improvement of GA...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28326205/shigella-sonnei-bacteremia-presenting-with-profound-hepatic-dysfunction
#13
Oluwaseun Shogbesan, Andrew Rettew, Bilal Shaikh, Abdullateef Abdulkareem, Anthony Donato
Worldwide, Shigellosis is a significant public health issue, associated with nearly one million deaths annually. About half a million cases of Shigella infection are reported annually in the United States. Shigella bacteremia is uncommon and generally seen in children and immunocompromised adults. We present a case of a Shigella sonnei bacteremia with marked hepatic derangement in a 27-year-old previously healthy homosexual male with history of Roux-en-Y gastric bypass, who presented to the emergency room with a 4-day history of loose watery stool, abdominal cramps, nausea and vomiting, and yellow skin of 2-day duration...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28321347/association-of-chronic-pancreatitis-and-malignant-main-duct-ipmn-a-rare-but-difficult-clinical-problem
#14
Zoltán Berger, Hernán De La Fuente, Manuel Meneses, Fernanda Matamala, Makarena Sepúlveda, Claudia Rojas
We report the case of a 70-year-old woman who consulted for recurrent short episodes of mild-to-moderate abdominal pain. Dilated main pancreatic duct was seen on CAT scan and magnetic resonance, with multiple calcifications and intraductal stones, typical in CP. However, for a more pronounced cystic dilatation in the pancreatic head, we could not exclude the coexistence of a main duct IPMN. ERCP was performed, with pancreatic sphincterotomy and extraction of pancreatic stones, but, at the same time, mucin extrusion was seen from the dilated duct through the papilla...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28321346/a-perplexing-case-of-abdominal-pain-that-led-to-the-diagnosis-of-zollinger-ellison-syndrome
#15
Adrienne Lenhart, Mona Hassan, Alireza Meighani, Omar Sadiq, Yousuf Siddiqui
Zollinger-Ellison syndrome (ZES) is a rare clinical disorder, characterized by hypersecretion of gastric acid and multiple ulcers distal to the duodenal bulb. This occurs via the release of gastrin by neuroendocrine tumors known as gastrinomas. Patients with ZES present with nonspecific GI symptoms, which often leads to a delay in diagnosis. Our patient is a 55-year-old female with chronic abdominal pain, nausea, and diarrhea. She underwent EGD, EUS, MRCP, CT scans, and cholecystectomy, which did not reveal the cause of her symptoms...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28321345/a-patency-capsule-remained-intact-in-the-colon-over-210-hours
#16
Yu Hihara, Satoru Joshita, Toshiharu Takahashi, Shinji Okaniwa, Yoshiki Mizukami, Yoshiyuki Nakamura
We present an unusual case of a 35-year-old male patient whom a patency capsule stayed in his gut without breaking. He has a history of Peutz-Jeghers syndrome and multiple abdominal surgeries. Prestudy was performed for abdominal searching, but a patency capsule remained in the colon over 9 days. He displayed neither abdominal nor obstructive symptoms in that period. We collected the patency capsule using colonoscopy after dilating a postoperative stricture at an anastomotic site of the rectum. Clinicians should bear in mind that patency capsules may become retained as distally as the colon in patients with a surgical history of the large intestine...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28299212/hemorrhagic-shock-as-complication-of-intramural-intestinal-bleeding
#17
Asma Ben Ali, Mohamed Ali Cherif, Walid Mhajba, Hamdi Hamdène Doghri, Malek Hassouna, Youssef Zied El Hechmi, Zouheir Jerbi, Ines Ben Hassen, Mohamed Habib Daghfous
Introduction. Mural intestinal hematoma (MIH) is an uncommon complication of anticoagulant therapy. Hemorrhagic shock has been rarely reported as a revealing modality. Results. We report two cases of shock induced by mural intestinal hematoma in patients under oral anticoagulant for aortic prosthetic valve and atrial fibrillation. Patients were admitted to the ICU for gastrointestinal tract bleeding associated with hemodynamic instability. After resuscitation, an abdominal CT scan has confirmed the diagnosis showing an extensive hematoma...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28261507/endoscopic-appearance-of-oropharyngeal-and-upper-gi-kaposi-s-sarcoma-in-an-immunocompromised-patient
#18
Umar Darr, Anas Renno, Zubair Khan, Turki Alkully, Maitham A Moslim, Sehrish Kamal, Ali Nawras
Introduction. Kaposi's sarcoma (KS) usually manifests as a cutaneous disease but GI manifestation is often rare. It is associated with human herpes virus-8 (HHV-8) and seen in immunocompromised patients. In the USA, use of highly active antiretroviral therapy (HAART) has drastically reduced incidence of KS in HIV patients. Case Presentation. A 65-year-old male with human immunodeficiency virus (HIV) was admitted to the intensive care unit (ICU) with cardiopulmonary arrest secondary to hyperkalemia of 7.5 meq/L...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28255476/a-rare-cause-of-primary-aortoenteric-fistula-streptococcus-parasanguinis-aortitis
#19
Fredy Nehme, Kyle Rowe, Cyrus Munguti, Imad Nassif
Primary aortoenteric fistula is a rare cause of upper gastrointestinal bleed but can lead to significant mortality if the diagnosis is delayed. Aortitis, characterized by inflammation of the aortic wall, is a rare cause of aortoenteric fistula. We present a case report of a 72-year-old male patient with infectious aortoenteric fistula secondary to Streptococcus parasanguinis, along with a review of the literature. This case demonstrates the importance of early diagnosis and aggressive surgical treatment of aortoenteric fistulae and recognizing infectious aortitis as a potential etiology...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28255475/solid-pseudopapillary-neoplasm-of-the-pancreas-in-young-male-patients-three-case-reports
#20
Akira Aso, Eikichi Ihara, Kazuhiko Nakamura, Irina Sudovykh, Tetsuhide Ito, Masafumi Nakamura, Tetsuo Ikeda, Nobuyoshi Takizawa, Yoshinao Oda, Shuji Shimizu
A preoperative diagnosis of solid pseudopapillary neoplasms (SPNs) in young male patients is difficult to achieve using radiological images. We herein present three cases of young male patients with relatively small SPNs. Endoscopic ultrasound (EUS) showed well-encapsulated, smooth-surfaced, heterogeneous solid lesions in all patients, and all preoperative diagnoses were achieved by EUS-guided fine needle aspiration (EUS-FNA). The final pathological diagnosis after surgery was an SPN with a Ki-67 labeling index of <2%...
2017: Case Reports in Gastrointestinal Medicine
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