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ACG Case Reports Journal

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https://www.readbyqxmd.com/read/29670926/-clostridium-tertium-an-unusual-cause-of-pyogenic-liver-abscess
#1
Mohamed Barakat, Steven Hernandez, Janeeka Benoit, Seyedmohammad Pourshahid, Yusufal Mamoon, George T Martin
Pyogenic liver abscess (PLA) is the result of portal vein pyemia, which usually originates from the hepatobiliary system or the gastrointestinal tract. Gram-negative organisms are the most common causative pathogens in PLA. Clostridium tertium is an anaerobic gram-positive, low-virulence organism that most commonly affects neutropenic patients with hematological malignancy and has not been reported to cause PLA. We report an unusual presentation of a C. tertium infection as a PLA in a previously healthy, immunocompetent patient with no identifiable source of portal pyemia...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29670925/pseudocirrhosis-in-a-patient-with-new-onset-dysphagia-and-history-of-ovarian-carcinoma
#2
Andrew Zanazanian, Amir Kalani, James H Tabibian
Pseudocirrhosis is an infrequently reported clinico-radiologic complication that primarily occurs in a subset of patients with a history of breast carcinoma metastatic to the liver that has been treated with systemic chemotherapy, particularly capecitabine, gemcitabine, trastuzumab, and/or paclitaxel. Even less common are cases of pseudocirrhosis secondary to other (i.e., non-breast) carcinomas. We describe a 43-year-old woman with a history of metastatic ovarian carcinoma treated several years prior with systemic chemotherapy who presented with progressive dysphagia and was found to have gastroesophageal junction adenocarcinoma and, incidentally, pseudocirrhosis...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29670924/interstitial-lung-disease-in-a-70-year-old-man-with-ulcerative-colitis
#3
Hampton W Collins, Jeanetta W Frye
Interstitial lung disease is a rare but increasingly recognized extraintestinal manifestation of inflammatory bowel disease that can have devastating consequences if left untreated. We report a case of ulcerative colitis-associated interstitial lung disease presenting with acute hypoxic respiratory failure during an ulcerative colitis flare. Gastroenterologists and pulmonologists should be aware of the numerous bronchopulmonary signs and symptoms that can suggest systemic illness in inflammatory bowel disease...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29619402/rare-metastasis-of-primary-pancreatic-adenocarcinoma-to-the-bladder
#4
Anup Shah, Praneet Korrapati, Jerome Siegel, Franklin Kasmin
Pancreatic cancer commonly metastasizes to the liver, lungs, stomach, bone, and bowel, but rarely does it spread to the bladder. We describe a case of a 66-year-old woman with diabetes mellitus who presented with abnormal liver function laboratory tests, abdominal discomfort, unintentional weight loss, and no urinary symptoms. Abdominal CT revealed a pancreatic and bladder mass. Pathology of the bladder mass confirmed metastatic adenocarcinoma of pancreaticobiliary origin. To our knowledge, this is only the third case of metastatic pancreatic cancer spreading to the bladder since 1953...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29619401/massive-gastrointestinal-hemorrhage-due-to-an-arterioenteric-fistula-from-a-hepatic-artery-pseudoaneurysm
#5
Nanae Takatori, Derek Patel
Hepatic artery pseudoaneurysms are a rare cause of upper gastrointestinal bleeding with a high mortality rate. We report a case of a 37-year-old woman who presented with massive gastrointestinal hemorrhage and was found to have an arterioenteric fistula from a hepatic artery pseudoaneurysm. Esophagogastroduodenoscopy revealed a 1.5-cm ulcer overlying a large mucosal bulge that compressed the lumen of the duodenal bulb. A vascular stent graft was placed successfully over the pseudoaneurysm neck. We report the first case of the unique intraluminal appearance of an enteric fistula related to a hepatic artery pseudoaneurysm...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29619400/unusual-presentation-of-duodenal-ulcer-presenting-with-duodenal-intussusception
#6
Shilpa Lingala, Andrew Moore, Siri Kadire, Sridhar Shankar, Kanak Das, Colin W Howden
We present a unique case of duodeno-duodenal intussusception from a duodenal bulb ulcer. A 38-year-old man presented with nausea, vomiting, and abdominal pain. Computed tomography showed duodenal intussusception. Esophagogastroduodenoscopy (EGD) showed a linear gastric ulcer and a duodenal bulb ulcer with an overlying blood clot. Helicobacter pylori status was positive. Intussusception resolved spontaneously without intervention. He completed treatment for H. pylori infection, and repeat EGD showed ulcer healing...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29619399/celiac-disease-and-secondary-amyloidosis-a-possible-causal-association
#7
Ankit Chhoda, Deepanshu Jain, Mradul Kumar Daga, Vineeta Batra
We report a rare case of secondary renal amyloidosis in a patient with probable celiac disease presenting as nephrotic syndrome. A 30-year-old man with chronic diarrhea presented with progressive anasarca for 2 years. On further evaluation, he had hypoalbuminemia, significant nephrotic-range proteinuria, and elevated levels of anti-tissue transglutaminase. Renal biopsy suggested deposition of amorphous Congo red-positive material in the glomerular mesangium, positive for amyloid A amyloidosis. Endoscopic duodenal biopsy suggested blunting of the villous architecture and chronic inflammation of the lamina propria...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29577057/malignant-peritoneal-mesothelioma-presenting-as-mucinous-ascites
#8
Zachary Field, Andreas Zori, Vikas Khullar, Manoela Mota, Michael Feely, Roberto J Firpi
We present a rare case of a 46-year-old man presenting with mucinous ascites secondary to malignant peritoneal mesothelioma (MPM) that was diagnosed via colonoscopy with biopsies. Both our findings and the clinical presentation were unique. While it is widely known that asbestos exposure is commonly associated with pleural mesothelioma, 6-10% of malignant mesotheliomas arise from the peritoneum. To date, only 4 cases of MPM with the primary tumor site in the colon have been described in the literature.
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29577056/an-overt-obscure-gastrointestinal-bleed-caused-by-a-primary-small-bowel-fibroblastic-reticular-cell-sarcoma
#9
Stephanie L Gold, Shirley Cohen-Mekelburg, Russell Rosenblatt, Jose Jessurun, Reem Sharaiha, Karim Halazun, David Wan
Small bowel bleeding should be considered in patients who continue to bleed despite a negative upper endoscopy and colonoscopy. The differential diagnosis of small bowel bleeding can include infection, inflammatory conditions, vascular malformations, and, rarely, malignancy. This report demonstrates a rare, primary, small bowel, reticular cell sarcoma presenting as an overt gastrointestinal bleed. These tumors are difficult to diagnose because they are rarely seen on traditional cross-sectional imaging and can present with multiple synchronous lesions throughout the intestinal tract...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29577055/perianal-mucinous-adenocarcinoma-diagnosed-by-histological-study-of-anorectal-abscess-with-fistula
#10
Shir Li Jee, Hizami Amin-Tai, Nik Qisti Fathi, Mohd Faisal Jabar
Perianal mucinous adenocarcinoma (PMA) is an oncologic rarity that poses a diagnostic and therapeutic dilemma for treating clinicians because there are few reported cases and an absence of definitive guidelines. We report a patient who had been treated with local surgery for recurrent perianal abscess with fistula for 3 years. Biopsy of the indurated tissue overlying his surgical scars revealed PMA. Neoadjuvant concurrent chemoradiotherapy followed by abdominoperineal resection was planned to address the locally advanced disease and ongoing sepsis...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29577054/successful-treatment-of-bleeding-rectal-varices-with-balloon-occluded-antegrade-transvenous-obliteration
#11
Dionne Rebello, Eric J Mao, Fadlallah G Habr, Van T Nguyen
We report the first described case in the United States of balloon-occluded antegrade transvenous obliteration (BATO) performed in a cirrhotic patient with recurrent bleeding from large rectal varices. This is a novel interventional radiology approach to treat bleeding rectal varices. Our patient was a poor candidate for transjugular intrahepatic portosystemic shunt and endoscopic band ligation. Successful BATO produced complete resolution of rectal varices and no further rectal bleeding. There are no established guidelines for the management of rectal varices...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29516020/small-bowel-obstruction-due-to-migration-of-a-transrectally-inserted-foreign-body
#12
Mohd Ilyas, Waseem Ahmed Sheikh, Jan Mohd Suhail, Omair Ashraf Shah, Irshad Ahmad Khan
No abstract text is available yet for this article.
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29516019/fishbone-migration-in-the-intrahepatic-bile-duct-after-pancreaticoduodenectomy
#13
Yoichi Koga, Akihiko Soyama, Amane Kitasato, Mitsuhisa Takatsuki, Susumu Eguchi
No abstract text is available yet for this article.
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29516018/emerging-role-of-vedolizumab-in-managing-refractory-immune-checkpoint-inhibitor-induced-enteritis
#14
Pietro Diana, Charoen Mankongpaisarnrung, Michael B Atkins, Jay C Zeck, Aline Charabaty
We report a 62-year-old white woman with metastatic choroidal melanoma who developed immune checkpoint inhibitor (ICI)-induced enteritis and grade 3 diarrhea refractory to steroids and infliximab. Her diarrhea quickly resolved after infusion of vedolizumab, and the patient was able to taper down steroids. Vedolizumab's mechanism of action and its gut specificity have the potential to reverse immune-induced enterocolitis without neutralizing or reversing the therapeutic benefit of ICI on the malignancy.
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29516017/ischemic-renal-injury-complicating-intragastric-balloon-insertion
#15
Emad S Aljahdli
A 25-year-old obese woman experienced ischemic renal injury as a complication of intragastric balloon (IGB) insertion for weight reduction. Although IGB is associated with a low risk of renal injury in the form of acute renal failure, this presentation has never been reported. The patient responded well to treatment, with complete clinical and radiologic resolution after balloon removal. She did not have an apparent cause of renal ischemia other than a significant compression of the renal vessels by the balloon as seen on imaging...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29516016/portal-cavernoma-mimicking-pancreatic-malignancy
#16
Vivian M Ussui, Lavinia Goldstein, Enrico Souto, Cynthia Levy
Portal cavernoma colangiopathy (PCC) is an uncommon cause of portal hypertension, and it is an important differential diagnosis of pancreatic malignancy given the expanded network of collateral vessels. On imaging studies, portal cavernoma can be seen as a hypoechoic mass, possibly associated with distal common bile duct obstruction. Most cases occur in non-cirrhotic patients. During the symptomatic phase, these patients carry a high-risk of complications related to sustained biliary obstruction. We report a unique patient with obstructive jaundice and a presumed pancreatic mass that proved to be a portal cavernoma complicated by PCC in the setting of nodular regenerative hyperplasia of the liver...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29484307/migration-of-a-lumen-apposing-metal-stent-into-the-colon
#17
Syed Kashif Mahmood, Pavlos Kaimakliotis
The introduction of lumen-apposing metal stents (LAMS) has been an important development in the management of pancreatic fluid collections. Stent migration out of pancreatic fluid collections into the stomach has been reported, despite the special anti-migratory design of the bi-flanged stent. Data on stent migration rates remain sparse, with some studies suggesting a migration rate of 3.3-5%. There have been no reported cases of LAMS migration outside of the stomach. We describe the first reported case of a transgastric LAMS migrating from the stomach and passing into the colon...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29484306/conundrum-of-a-large-bowel-neoplasm-collision-tumor
#18
Antonio R Soto, Ekie G Vazquez, Nicole M Grigg-Gutierrez, Priscilla Magno-Pagatzaurtundua, William Cáceres, Doris H Toro
A 79-year-old Hispanic man was admitted to the intensive care unit with symptomatic iron-deficiency anemia and watery diarrhea. Radiological images revealed diffuse colonic wall thickening, a soft-tissue fullness in the ascending colon, and multiple mesenteric lymphadenopathies. Colonoscopy showed multiple aphthous ulcers throughout the colon and a large deep ulcer with irregular raised borders in the rectosigmoid area. Histological exam of the ulcers showed severe ulcerative colitis, while biopsy of the deep ulcer revealed a well-differentiated adenocarcinoma...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29484305/abdominal-abscess-related-to-endoscopically-placed-aspireassist%C3%A2-device
#19
Mihajlo Gjeorgjievski, Naveen Reddy, Veslav Stecevic, Mitchell S Cappell
We report a 55-year-old diabetic woman with abdominal pain, pyrexia, and leukocytosis 3 months after aspiration tube placement. Abdominal computed tomography revealed a hypodense mass (10.8 × 7.2 cm) extending into the right anterior abdominal wall. Aspiration of the abscess revealed purulent fluid that grew Streptococcus intermedius . The aspiration tube was removed and 4 endoclips were deployed to close the intragastric stoma. The patient recovered well with 21 days of antibiotics, with resolution of the abscess and full wound healing...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29430470/transjugular-intrahepatic-portosystemic-shunt-for-refractory-variceal-bleeding-in-a-patient-with-a-left-ventricular-assist-device
#20
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
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