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ACG Case Reports Journal

Anusha Shirwaikar Thomas, Jerry Estep, David W Victor
Transjugular intrahepatic portosystemic shunt (TIPS) is an attractive therapeutic option in cirrhotic patients with recurrent variceal bleeding refractory to medical and endoscopic therapy. There is little known about the use of TIPS in patients with left ventricular assist devices (LVAD). We describe a patient with a durable continuous-flow LVAD and concurrent decompensated cardiac cirrhosis who underwent successful TIPS placement for recurrent variceal bleeding. The patient has had no rebleeding or encephalopathy in >12 months since TIPS placement...
2018: ACG Case Reports Journal
Tara T Ghaziani, Joy J Liu, Zhenghui G Jiang, Imad Nasser, Khalid Khwaja, Robert A Fisher, Myrna Nahas, Michael P Curry
Posttransplant lymphoproliferative disorder (PTLD) is a serious complication that accounts for up to 20% of malignancies after solid organ transplantation. We describe a rare case of isolated PTLD in the adrenal gland occurring 7 months after liver transplant in a patient who developed a primary Epstein-Barr virus infection. He was treated with rituximab and his immunosuppression regimen was minimized. We review the incidence, pathogenesis, presentation, and management of PTLD in the liver-transplant population...
2018: ACG Case Reports Journal
Hirokazu Honda, Kenji Nakamura, Naoki Ishii, Koyu Suzuki, Katsuyuki Fukuda
A 37-year-old man presented to our hospital for early rectal cancer accompanied by mucosal prolapse syndrome. Biopsy confirmed an adenocarcinoma, and endoscopic ultrasonography indicated proximity to the dentate line but no submucosal invasion. The tumor was removed en bloc via endoscopic submucosal dissection without complications, and its margin was free of tumor cells. The total procedure duration was 37 minutes, and the resected specimen measured 23 × 13 mm. There was no recurrence during the 3-year observation period...
2018: ACG Case Reports Journal
Taseen A Syed, Zain Ul Abideen Asad, George Salem, Kanika Garg, Erin Rubin, Nelson Agudelo
Dissecting cellulitis is an inflammatory disease of the skin. We report a case of recurrent dissecting cellulitis in a patient with Crohn's disease. A 31-year-old man with a history of purulent scalp lesions presented with night sweats, weight loss, abdominal pain, and hematochezia. Colonoscopy revealed a diffuse friable mucosa with extensive pseudopolyps. Scalp biopsy demonstrated epidermoid inclusion cysts with granulation tissue and chronic inflammatory cell infiltration, indicative of dissecting cellulitis...
2018: ACG Case Reports Journal
Viviana Parra, Javier Preciado Aponte, Margarita Huertas Quintero, Sara Garcia, Luis Carlos Sabbagh
No abstract text is available yet for this article.
2018: ACG Case Reports Journal
Amin H Nassar, Baraa M Abdul-Jawad, David S Barnes
Hepatitis C-induced cholestatic hepatitis is a well-known fatal complication of postorthotropic liver transplantation and prolonged immunosuppression. Recent studies on direct-acting antiviral agents have shown promising results in terms of morbidity and mortality of this condition in postorthotropic liver, heart, and renal transplant patients. However, hepatitis C-induced cholestatic hepatitis remains a highly fatal condition in non-transplant patients. We report the first-ever use of the oral direct-acting antiviral combination, elbasvir and grazeprevir, in the treatment of a non-liver transplant patient with cholestatic hepatitis...
2018: ACG Case Reports Journal
Benjamin S Robey, Anne F Peery, Evan S Dellon
Marfan syndrome is an autosomal dominant disorder involving mutation in the FBN1 gene, which encodes fibrillin-1, a protein critical to maintain the integrity of connective tissue. A mutation in this gene can affect multiple organ systems, but it is not classically associated with gastrointestinal complications. We describe a man with Marfan syndrome with multiple small bowel diverticula leading to small intestinal bacterial overgrowth and recurrent small bowel perforations.
2018: ACG Case Reports Journal
Patrick Stoner, Alexander Schlachterman, Eric Hilgenfeldt, Peter Draganov
No abstract text is available yet for this article.
2018: ACG Case Reports Journal
Andrew M Moon, Sarah A Buckley, Nicholas M Mark
Cannabinoid hyperemesis syndrome (CHS) is a clinical entity in which marijuana users develop nausea, vomiting, and abdominal pain that improves with hot water bathing or cannabis cessation. Previous models suggest that CHS arises solely from the derangement of cannabinoid receptor type 1 signaling. However, involvement of transient receptor potential vanilloid subtype 1 (TRPV1) receptor, which is activated by marijuana, capsaicin, and heat, could fill gaps in existing models, including the enigmatic role of hot water bathing...
2018: ACG Case Reports Journal
Jeerawat Maytapa, Kessarin Thanapirom, Sombat Treeprasertsuk, Piyawat Komolmit, Bundit Chaopathomkul, Pinit Kullavanijaya
We report a 70-year-old man with autosomal dominant polycystic kidney disease (ADPKD) who presented with right-sided extended-spectrum beta-lactamases Escherichia coli empyema thoracis. Chest and abdominal computed tomography showed hepatopleural fistula. The patient refused a surgical operation and was treated with tube thoracotomy, percutaneous drainage of dominant liver cyst, and intravenous antibiotics. His symptoms improved after 2 months of nonsurgical treatment.
2018: ACG Case Reports Journal
Rahul Kataria, Sandar Linn, Zubair Malik, Abbas E Abbas, Henry Parkman, Ron Schey
Gastroparesis, caused by delayed emptying of the stomach, has been shown to be associated with Nissen fundoplication. However, symptomatic rapid emptying of the stomach is rare after Nissen fundoplication, and its treatment is often challenging. We report 2 patients with dumping-like syndrome post-fundoplication with marked improvement of symptoms after dietary management and medical treatment.
2018: ACG Case Reports Journal
Daniela G Vinsard, Lady Katherine Mejia Perez, Aziza Nassar, Maria I Vazquez Roque
A 21-year-old woman presented to our clinic after 7 years of abdominal pain, diarrhea, and iron-deficiency anemia. Initial upper endoscopy revealed severe inflammation and nodularity of the gastric body and active Helicobacter pylori infection. After eradication therapy, esophagogastroduodenoscopy showed gastric atrophy with nodularity resolution. Histopathology revealed scattered plasma cells, eosinophils, and collagen deposition suggestive of collagenous gastritis. H. pylori can induce proinflammatory cytokines, resulting in fibroblast upregulation...
2017: ACG Case Reports Journal
Ihab I El Hajj, Glen A Lehman, Temel Tirkes, Stuart Sherman
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
Ruiyao Huang, Amine Benmassaoud, Serge Mayrand
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
Divyanshoo R Kohli, Munazza Anis, Tilak Shah
An 82-year-old man was referred for endoscopic ultrasound of an ulcerated subepithelial mass in the duodenal sweep. The mass was initially identified during upper endoscopy for coffee-ground emesis. During endoscopic ultrasound, a 21-mm hypoechoic ulcerated subepithelial mass with a duct-like structure was identified. During suction to appose the lesion against the tip of the echoendoscope, the ulceration opened into a fistulous tract with drainage of bile and stones. Subsequent abdominal imaging demonstrated that the mass-like duodenal lesion abutted the gallbladder, which had an air-fluid level...
2017: ACG Case Reports Journal
Bryant Megna, Sumona Saha, Arnold Wald, Rashmi Agni, Kristina A Matkowskyj, Freddy Caldera
Microscopic colitis (MC) has rarely been described to be the cause of watery diarrhea in those with established inflammatory bowel disease (IBD), and instead has been presented as a herald syndrome to eventual IBD or incidentally found in asymptomatic IBD patients. We report a case series of 7 patients with IBD who presented with a watery diarrheal exacerbation due to new-onset MC. We propose that new-onset MC should be considered in the differential diagnosis of watery diarrhea occurring in patients with long-standing IBD and that evaluation should include colonoscopy with biopsies obtained throughout the colon...
2017: ACG Case Reports Journal
Remil Simon, Evon Zoog, George Philips, Jacob Dowden
Intrapancreatic enteric duplication cysts are exceedingly rare, and the clinical presentation varies. We present a 48-year-old man with significant alcohol and tobacco abuse and a diagnosis of groove pancreatitis complicated by a pancreatic duct stricture, pseudocyst, and recurrent biliary obstruction. Due to failure of endoscopic therapy and concerning findings on endoscopic ultrasound with negative pathology, he underwent a pancreaticoduodenectomy. Pathology revealed an intrapancreatic enteric duplication cyst, minimal chronic pancreatitis changes associated with pancreaticobiliary strictures, and no evidence of malignancy...
2017: ACG Case Reports Journal
Ryan Kahl, Kruti Patel, Khalid George, Michael Piper
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
Sardar Shah-Khan, Hiren Vallabh, Jon Cardinal, John Nasr
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
Collette E Abbott, Ruliang Xu, Samuel H Sigal
Drug-induced injury (DILI) is a frequent cause of abnormal liver tests and a leading cause of liver failure in the United States. Colchicine has long been used as a systemic anti-inflammatory agent for treatment of gout by inhibiting mitotic activity and neutrophil function. We present the first case of colchicine-induced hepatoxicity, supported by histopathologic findings characteristic of colchicine-induced injury and resolution of liver enzyme abnormalities after its discontinuation. Colchicine-associated DILI has implications for the evaluation of patients with abnormal liver tests and gout, especially for patients with alcoholism and non-alcoholic fatty liver disease, in whom there is an increased incidence of gout...
2017: ACG Case Reports Journal
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