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ACG Case Reports Journal

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https://www.readbyqxmd.com/read/28184378/relapse-of-hcv-genotype-1b-infection-after-sofosbuvir-ledipasvir-treatment-presenting-as-de-novo-cryoglobulinemic-vasculitis
#1
Mohammad Qasim Khan, Alan D Moreno, Nora Joseph, George Kim, Claus J Fimmel
Relapse of hepatitis C virus (HCV) genotype 1 infection after combination therapy with sofosbuvir and ledipasvir is unusual. We report a treatment-naïve, non-cirrhotic patient in whom the relapse of genotype 1b HCV infection was accompanied by de novo cryoglobulinemic vasculitis and glomerulonephritis, requiring hemodialysis for acute renal failure. Sequence analysis revealed several resistance-associated variants in the HCV NS5a gene but not in NS3/4A. The patient's vasculitis was successfully treated with immunosuppression and plasmapheresis, followed by retreatment of HCV with a combination of sofosbuvir, simeprevir, and ribavirin...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28184377/novel-use-of-a-uniquely-designed-lumen-apposing-metal-stent-in-benign-gastric-outlet-obstruction-in-two-patients
#2
Ross Pinson, Induruwa Pathirana, John Magulick, Jeremy Domanski, Emuejevoke Okoh, Craig Womeldorph
Current guidelines recommend management of benign gastric outlet obstruction (GOO) with serial dilations. Self-expanding metal stents are effective, but their use is complicated by high rates of migration. We present two cases from our institution where a uniquely designed, lumen-apposing metal stent (LAMS) was successfully used to alleviate benign GOO without stent migration.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28184376/seronegative-adult-autoimmune-enteropathy-in-a-male-traveler
#3
Patrick McCabe, Latifat Alli-Akintade, Jesse Stondell
Autoimmune enteropathy (AIE) is rare but damaging. The lack of consistent objective findings makes diagnosis a challenge. A 45-year-old male developed noninfectious diarrhea with significant weight loss and electrolyte abnormalities. Computed tomography delineated enteritis. Colonoscopy and esophagogastroduodenoscopy showed villous atrophy, chronic inflammation, and ulceration of the terminal ileum and cecum. Pathology showed cryptitis with apoptosis and abscesses throughout the small and large bowel and absent goblet cells...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28184375/stomach-with-glasses-a-striking-foreign-body
#4
Shifa Umar, Ghita Moussaide, Mohammad Bilal, Elie Aoun
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28184374/endosonography-and-confocal-endomicroscopy-of-primary-keratinizing-squamous-cell-carcinoma-of-the-pancreas
#5
Rohan M Modi, Amrit K Kamboj, Rulong Shen, Somashekar G Krishna
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28184373/successful-treatment-of-mixed-hepatitis-c-genotypes-in-a-cirrhotic-patient-with-an-all-oral-interferon-free-regimen
#6
Ayman Ahmed Sakr, Jasmine M Hanifi, Ming Valerie Lin
Mixed hepatitis C virus (HCV) genotype infection is emerging with improved methods of detection. It is commonly seen in hemodialysis patients and intravenous drug users due to repeated HCV exposure and absence of protective immunity, and can contribute to treatment failure. Direct-acting antiviral regimens have been extensively studied in patients with different individual HCV genotypes; however, there are no reported data on their use in patients with mixed HCV genotype. We present a case of mixed HCV genotype 1a and 2 infection in a decompensated cirrhotic patient treated successfully with sofosbuvir, ledipasvir, and ribavirin...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28184372/why-you-should-consider-an-advanced-training-fellowship-in-inflammatory-bowel-disease
#7
Zane Gallinger
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28144619/two-complex-cases-of-hermansky-pudlak-syndrome-highlight-a-potential-biologic-explanation-for-an-associated-crohn-s-disease-phenotype
#8
M Anthony Sofia, Atsushi Sakuraba, David T Rubin
Hermansky-Pudlak syndrome (HPS) is a rare autosomal recessive disorder characterized by oculocutaneous albinism and a lack of dense granules in platelets. HPS types 1 and 4 are associated with a granulomatous enterocolitis that is phenotypically indistinguishable from Crohn's disease. We present two cases of HPS-associated Crohn's disease phenotype in which the patients were refractory to standard medical management. The pathophysiology of HPS is mediated by single-gene defects that alter endosome trafficking, and we hypothesize that this mechanism leads to the observed association with a CD phenotype...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28144618/you-are-what-you-eat-a-case-of-nematode-induced-eosinophilic-esophagitis
#9
Mona Rezapour, Nikhil Agarwal
Human anisakiasis is acquired through eating raw or undercooked saltwater fish or squid. Infestation with living larvae caused by eating parasitized fish often times results in gastroenteritis. It mainly involves the stomach and small intestine with no reported cases of eosinophilic esophagitis caused by Anisakidea. A 41-year-old man presented for the evaluation of 1 year of dysphagia to solid foods and was found to have endoscopic findings consistent with eosinophilic esophagitis with pathology showing 100 eosinophils per high-power field...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28144617/foreign-body-penetration-through-jejunal-loops-causing-renal-artery-thrombosis-and-renal-infarct
#10
Najib Nassani, Elie El-Charabaty, Patricia Nasr, Iskandar Barakat, Sherif Andrawes
Foreign body ingestion is common, although perforation after ingestion is rare. We report a case of an ingested sharp wooden stick that perforated the proximal jejunum toward the renal vasculature, causing segmental renal artery thrombosis and renal infarct. The patient presented with severe abdominal pain and vomiting. A computed tomography scan revealed a linear opacity corresponding to the foreign body. The wooden stick was removed endoscopically through deep-push enteroscopy with a rat-tooth forceps. We report this unique case of perforation by a foreign body through the proximal jejunum to the left kidney, which was managed endoscopically...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28144616/steroid-induced-psychosis-after-eus-guided-celiac-plexus-blockade
#11
David C Olson, Jason J Lewis
A 46-year-old female with no previous personal or family psychiatric history underwent endoscopic ultrasound (EUS)-guided celiac plexus blockade (CPB) to treat pain related to cystic fibrosis transmembrane conductance regulator-associated chronic pancreatitis. She had excellent response to her first three CPBs using bupivacaine and triamcinolone. The patient's subsequent CPBs were complicated by symptoms of racing thoughts, delusional thinking, and insomnia. She was diagnosed with acute psychosis secondary to triamcinolone...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28144615/isolated-ileal-stricture-secondary-to-antigen-negative-gi-histoplasmosis-in-a-patient-on-immunosuppressive-therapy
#12
Kyle M Rowe, Michael Green, Fredy Nehme, Nathan Tofteland
We present a case of antigen-negative disseminated histoplasmosis manifesting as an isolated ileal stricture in a patient on chronic infliximab and methotrexate. Diagnosis can be challenging due to imperfect tests, and this condition should remain in the differential, even with negative testing. Mortality of untreated disseminated histoplasmosis can be as high as 80%.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28144614/midgut-volvulus-as-a-complication-of-intestinal-malrotation-in-pregnancy
#13
Artur Sérgio Gião Antunes, Bruno Peixe, Horácio Guerreiro
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28144613/complete-esophageal-obstruction-after-endoscopic-variceal-band-ligation-in-a-patient-with-a-sliding-hiatal-hernia
#14
Munthir Mansour, Yousef Abdel-Aziz, Hesham Awadh, Nihar Shah, Akash Ajmera
Complete esophageal obstruction is a rare complication of endoscopic variceal banding, with only 6 cases in the English literature since the introduction of endoscopic variceal banding in 1986. We report a case of complete esophageal obstruction following esophageal banding due to entrapment of part of a sliding hiatal hernia. To our knowledge, our case is one of few with esophageal obstruction post-banding, and the first associated with a hiatal hernia. We recommend caution when performing esophageal banding on patients with a hiatal hernia...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28144612/autoimmune-pancreatitis-diagnosed-with-core-biopsy-obtained-from-a-novel-fork-tip-eus-needle
#15
Tossapol Kerdsirichairat, Sameer D Saini, Priscilla R Chamberlain, Anoop Prabhu
The endoscopic diagnosis of autoimmune pancreatitis from histologic criteria remains challenging as it requires adequate architectural details rather than cytology alone. A 67-year-old man presented with progressive abdominal pain and weight loss. Cross-sectional imaging showed inflammatory changes of the pancreatic body and tail and periaortitis on abdominal computed tomography, but normal serum immunoglobulin G4. A mass-like lesion of the pancreatic body and tail was identified on endoscopic ultrasonography...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28138450/presternal-esophageal-bypass-late-sequelae-of-an-old-fashioned-operation
#16
Andrea Sironi, Emanuele Asti, Luigi Bonavina
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28138449/budesonide-related-iatrogenic-cushing-s-syndrome-in-microscopic-colitis
#17
Kartikeya Tripathi, Thomas Dunzendorfer
Budesonide is the treatment of choice for microscopic colitis because of its excellent risk to benefit ratio. It is a potent, well-absorbed corticosteroid, but because of a high rate of first-pass metabolism in the liver, its systemic bioavailability is low. It has fewer corticosteroid-related adverse effects than prednisone, and adrenal suppression is considered to be rare. We present a middle-aged woman with lymphocytic colitis whose symptoms responded to budesonide but developed budesonide-related iatrogenic Cushing's syndrome...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28138448/gastric-ischemia-as-a-rare-cause-of-hematemesis
#18
R Brooks Vance, Christian A Mayorga
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28138447/diarrhea-concealing-a-duodenal-cecal-fistula-secondary-to-appendiceal-mucinous-neoplasm
#19
Su Aung, Amanda Cheung, Charlene Prather, Jinping Lai
Primary mucinous adenocarcinoma of the appendix is a rare gastrointestinal malignancy. Fistulous tract formation is a complication that is cited in literature. An 85-year-old man with multiple comorbidities presented with several weeks of persistent non-bloody diarrhea. Laboratory work-up was non-diagnostic. Abdominal imaging with barium contrast showed an enterocolonic fistulous tract extending from the duodenum to the cecum involving an enlarged appendiceal mass. Subsequent biopsy confirmed mucinous appendiceal neoplasm with peritoneal spread to the liver and mesentery...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28138446/management-of-an-accessory-bile-duct-leak-following-pancreaticoduodenectomy-a-novel-approach-utilizing-a-percutaneous-and-endoscopic-rendezvous
#20
George A Rapp, Kari J Nelson, David K Imagawa, Jason Y Huang, John G Lee
Biliary leaks are uncommon but morbid complications of pancreaticoduodenectomies, which have historically been managed with percutaneous drainage, reoperation, or a combination of both. We report a de novo percutaneous-endoscopic hepaticojejunostomy from an anomalous right hepatic duct injured during pancreaticoduodenectomy to the afferent bowel limb. The percutaneous-endoscopic hepaticojejunostomy was stented to allow for tract formation with successful stent removal after 5.5 months. One year after the creation of the percutaneous-endoscopic hepaticojejunostomy, the patient remains clinically well without evidence of biliary leak or obstruction...
2017: ACG Case Reports Journal
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