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ACG Case Reports Journal

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https://www.readbyqxmd.com/read/28706962/posttransplant-lymphoproliferative-disorder-of-the-small-bowel-as-an-unexpected-cause-of-iron-deficiency-anemia-decades-after-heart-transplantation
#1
Amanda Siegel, Justin Boike, Itishree Trivedi, Rena Yadlapati
Although rare, gastrointestinal posttransplant lymphoproliferative disorder (PTLD) can lead to abdominal pain or gastrointestinal bleeding in patients with a history of solid-organ transplantation. We describe a case of isolated gastrointestinal PTLD in a patient who presented with acute on chronic iron deficiency anemia 26 years after heart transplant. A comprehensive endoscopic evaluation with video capsule endoscopy and small bowel enteroscopy revealed a large cratered ulceration in the small bowel with abnormal mucosal changes, which led to the diagnosis of PTLD...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28706961/multiple-myeloma-presenting-as-acute-liver-failure
#2
Stephanie Cull, David J Westrich, Ruchi Bhatia, Jinping Lai, Alex S Befeler
Liver failure is rarely caused by multiple myeloma (MM). We present an unusual case of MM initially presenting as acute liver injury. A 79-year-old man with new-onset fatigue, decreased appetite, and no history of liver disease was found to have evidence of hepatic decompensation. Liver biopsy demonstrated diffuse plasma cell infiltration, and MM was confirmed with bone marrow biopsy. Chemotherapy was initiated, but the patient decompensated and died due to respiratory failure. MM should be considered on the differential for acute decompensated liver disease...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28706960/acute-interstitial-nephritis-associated-with-sofosbuvir-and-daclatasvir
#3
Taha Ashraf, William Majoni
Although new heptatis C virus treatments have increased efficacy and improved safety profiles, they also come with risk. We describe a 66-year-old white man with Child-Pugh A cirrhosis secondary to heptatis C virus genotype 3, who suffered from an acute kidney injury after treatment with sofosbuvir and daclatasvir. Kidney biopsy demonstrated evidence of acute tubular interstitial nephritis consistent with a drug reaction. A trial of steroid therapy was effective, and his creatinine continues to improve significantly...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28670597/solitary-polypoid-angiodysplastic-lesion-mimicking-a-tumor-in-the-jejunum
#4
Abhishek D Polavarapu, Mayurathan Kesavan, Vivek V Gumaste, Monika Wrzolek, Elias Purow
Small bowel bleeding should be considered in patients with overt or occult gastrointestinal hemorrhage after normal upper and lower endoscopic examination. Angiodysplasia appearing as multiple flat vascular tufts is the most common cause of small bowel bleeding in patients over 40 years old. Polypoid angiodysplasia, however, is extremely rare. This report illustrates a unique case of solitary polypoid angiodysplasia in the jejunum of an adult with chronic kidney disease, who presented with an occult gastrointestinal bleed...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28670596/actinomycosis-causing-recurrent-perianal-fistulae
#5
Mariana Ferreira Cardoso, Carla Carneiro, Luís Carvalho Lourenço, Catarina Graça Rodrigues, Sara Folgado Alberto, Ana Alagoa João, Ricardo Rocha, Vasco Geraldes, Ana Costa, Jorge Reis, Vítor Nunes
Actinomycosis is a rare but easily curable infection that should be considered in the differential diagnosis of perianal fistulizing disease. We present the case of a 26-year-old woman with complex perianal fistulae, including trans-sphincteric and suprasphincteric fistulous tracts and a rectovaginal fistula, requiring multiple abscess drainages, seton placement, and antibiotic courses, with little improvement. After extensive investigation, Actinomyces spp. was identified in anal cytology. The patient underwent a 6-week course of intravenous penicillin followed by oral amoxicillin, with remarkable improvement...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28670595/massive-hepatic-infarction-caused-by-hellp-syndrome
#6
Adam E Mikolajczyk, John Renz, Geraldine Diaz, Lindsay Alpert, John Hart, Helen S Te
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28670594/intravascular-papillary-endothelial-hyperplasia-of-the-jejunum-as-a-cause-of-obscure-overt-gastrointestinal-bleeding
#7
Jonathan Gotfried, Raul Berio Dorta, Jennifer Maranki
Intravascular papillary endothelial hyperplasia (IPEH), or Masson's tumor, is a rare, benign vascular lesion characterized by reactive endothelial proliferation with venous stasis and thrombus. Lesions typically arise in vascular regions of the head and neck or extremities, but involvement of other organ systems has been reported. Clinically, IPEH mimics other benign lesions (hemangiomas) and malignant neoplasms (angiosarcoma) depending on the affected site. Diagnosis is essential because local excision of certain IPEH subtypes is curative...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28670593/laparotomy-assisted-endoscopic-injection-of-jejunal-varices-for-overt-small-bowel-bleeding
#8
Divyanshoo R Kohli, Marlon F Levy, George B Smallfield
A 54-year old male liver transplant recipient with Roux-en-Y choledochojejunostomy was admitted for symptomatic anemia. Despite endoscopies and a bleeding scan, active bleeding was not visualized. Angiography and abdominal computed tomography demonstrated possible jejunal varices at the choledochojejunal anastomosis. Double-balloon enteroscopy demonstrated varices with overlying clots in the Roux limb at the anastomosis. Due to the extensive loop formation and unstable position of the endoscope, therapeutic intervention could not be performed...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28620624/early-gastric-cancer-associated-with-a-gastric-lipoma
#9
Ai Sato, Atsushi Irisawa, Goro Shibukawa, Akane Yamabe, Mariko Fujisawa, Noriyuki Arakawa, Yoshitsugu Yoshida
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28620623/resolution-of-diffuse-intrahepatic-biliary-strictures-after-chemotherapy-for-metastatic-ovarian-cancer
#10
Daniel Lew, Vinay Sundaram, Brad D Barrows, Simon K Lo, Srinivas Gaddam
Sclerosing cholangitis and cholestatic jaundice secondary to metastatic disease is a rare complication. We report a rare case of secondary sclerosing cholangitis (SSC) due to lymphatic spread from ovarian cancer with complete resolution after chemotherapy. The diagnosis of SSC from metastatic ovarian cancer was clinically challenging, as endoscopic retrograde cholangiopancreatography revealed irregular hepatic ducts consistent with sclerosing cholangitis, but it did not identify any malignant cells. The final diagnosis was made with liver biopsy revealing high-grade metastatic Mullerian carcinoma...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28620622/intrahepatic-migration-of-gastrostomy-tube-after-inadvertent-transhepatic-peg-placement
#11
Catarina Atalaia-Martins, Sandra Barbeiro, Pedro Marcos, Inês Gil, Isabel Cotrim
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28584848/acute-shunt-failure-due-to-perforation-of-ventriculoperitoneal-shunt-tubing-during-percutaneous-gastrostomy
#12
Andrew C Vivas, Michael Wilsey, Joseph K Potthast, Gerald F Tuite
The placement of a percutaneous endoscopic gastrostomy (PEG) in a patient with a pre-existing ventriculoperitoneal shunt is generally regarded as safe. A critical but often overlooked technical consideration is confirmation of the course of the distal shunt tube prior to PEG insertion. We present the case of a 4-month-old male infant with shunted hydrocephalus who experienced shunt malfunction due to perforation of the distal shunt tubing after PEG placement.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28584847/acute-appendicitis-caused-by-an-echinococcal-brood-capsule-unmasks-an-asymptomatic-hepatic-hydatid-cyst
#13
Krishnendu Mondal, Rupali Mandal
Hydatidosis is an endemic helminthic disease in the cattle-grazing regions of Asia. It is usually caused by the cestode Echinococcus granulosus. Internal organs, particularly the liver and lungs, are predominantly affected, but the appendix is only rarely involved with the formation of characteristic hydatid cyst. We present a unique case of appendiceal hydatidosis in an 18-year-old woman with acute appendicitis. Her preoperative abdominal ultrasound revealed an asymptomatic hydatid cyst in the liver. An echinococcal brood capsule was detected postoperatively within the appendicular lumen under microscope...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28584846/rare-esophageal-migration-of-axios-stent-used-for-walled-off-pancreatic-necrosis-drainage
#14
Yousef Abdel-Aziz, Anas Renno, Tariq Hammad, Ali Nawras
The AXIOS stent (Boston Scientific, Marlborough, MA) is a novel lumen-apposing self-expandable metallic stent designed for enteric drainage of nonadherent lumens. Efficacy and safety of using the AXIOS stent for pancreatic fluid drainage have been consistently shown in several studies. Although it is less common with this novel stent, stent migration still may happen. We present a case of AXIOS stent migration into the esophagus.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28584845/shoulder-mass-as-the-initial-presentation-of-metastatic-hepatocellular-carcinoma
#15
Derek B Laskar, Ghulam Ilyas, Daniel Diaz, Charles Shao
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28584844/castleman-disease-presenting-as-an-abdominal-mass
#16
Farnaz Shariati, Elizabeth Verter, Wendy Chang, Li Huang, Virendra Joshi
Unicentric Castleman disease is a rare condition of lymphoid hyperplasia, of which only 15% of cases occur in the abdomen. We report a 66-year-old man who presented with complaints of abdominal pain. Computed tomography scans revealed nephrolithiasis and a homogeneous calcified mass between the pancreas and stomach and several para-pancreatic nodes. Direct visualization during exploratory laparotomy revealed a mass on the lesser curvature of the stomach. Pyloromyotomy and mass resection were performed. Biopsy showed reactive lymphoid hyperplasia consistent with the hyaline vascular variant of Castleman disease...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28584843/ruptured-dissecting-intramural-duodenal-hematoma-following-endoscopic-retrograde-cholangiopancreatography
#17
Eric Weiss, Madeline Tadley, Pak S Leung, Mark Kaplan
A 34-year-old woman with schizophrenia developed abdominal pain. Ultrasound demonstrated cholelithiasis and a dilated biliary tree. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP), sphincterotomy, and extraction of gallstones from the common bile duct. She developed post-procedure fever, tachycardia, and abdominal pain and was taken to the operating room for urgent cholecystectomy with intraoperative cholangiogram. At laparotomy, an intramural dissecting duodenal hematoma was discovered, which extended the length of the duodenum and ruptured...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28584842/diffuse-large-b-cell-lymphoma-with-secondary-hemophagocytic-lymphohistiocytosis-presenting-as-acute-liver-failure
#18
Ruchi Patel, Haren Patel, William Mulvoy, Sumit Kapoor
Hemophagocytic lymphohistiocytosis (HLH) and newly diagnosed malignant infiltration of liver are rare presentations of acute liver failure associated with poor prognosis. We report a case of a patient with acute liver failure caused by malignant infiltration by diffuse large B-cell lymphoma and secondary HLH.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28516112/hemorrhagic-cystitis-in-a-liver-transplant-recipient-secondary-to-bk-virus
#19
Faisal Kamal, Bilal Ali, Matthew Barnes, Sehrish Kamal, Satheesh Nair, Humberto Gonzalez
The association between BK virus infection and hemorrhagic cystitis (HC) in hematopoietic stem cell transplant (HSCT) recipients is well established. However, BK virus-associated HC has not been described in liver transplant (LT) recipients. We present a case of BK virus-associated HC in a LT recipient. Our patient presented with worsening liver function tests 2 years after transplantation and was found to have acute cellular rejection. He was treated with increased immunosuppression and subsequently developed hematuria...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28516111/transhiatal-herniation-of-the-pancreas-a-rare-cause-of-acute-pancreatitis
#20
Jeremy Wang, Adarsh M Thaker, Wael Noor El-Nachef, Rabindra R Watson
Transhiatal herniation of the pancreas is rare. Acute pancreatitis secondary to this phenomenon is particularly unusual. A 102-year-old woman presented with 1 day of severe chest pain, vomiting, dyspnea, and diaphoresis. Serum lipase was elevated, and computed tomography angiogram of the chest and magnetic resonance cholangiopancreatography revealed a hiatal hernia containing the pancreas, with associated findings of pancreatitis. Pancreatitis in this setting may be due to repetitive trauma or ischemia from sliding, intermittent folding of the pancreatic duct, or pancreatic incarceration...
2017: ACG Case Reports Journal
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