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ACG Case Reports Journal

Brigit van Dijk, Dick van Geldere, Maarten Meijssen, Robert Pierik
Diverticula of the colon are the most common cause of lower gastrointestinal bleeding in adults. In cases of persistent loss of blood or severe acute hemorrhage, treatment is required. However, if these modern intervention techniques are inadequate, surgical resection of the colon may be required. Diverticular bleeding often concerns patients with a high surgical risk, so a less invasive treatment is preferable. A forgotten but excellent treatment, namely that of the obsolete barium contrast enema to staunch diverticular bleeding, is the focus of this case series...
2018: ACG Case Reports Journal
Benjamin Chaucer, Nicole Smith, Derek Beatty, Manajyoti Yadav
Parvimonas micra is an obligate anaerobic bacterium and a known commensal of the human oral cavity and gastrointestinal tract. It is rarely associated with infections outside the oral cavity. Recently it has been isolated as a causative agent in a variety of systemic infections, but it has never been previously identified to cause a hepatic abscess. We report a 90-year-old woman with multiple hepatic abscesses caused by P. micra .
2018: ACG Case Reports Journal
Luiz Gustavo de Quadros, Manoel Dos Passos Galvão Neto, Eduardo Grecco, Thiago Ferreira de Souza, Roberto Luiz Kaiser, Josemberg Marins Campos, André Teixeira, Admar Concon Filho, Guilherme Macedo, Marco Silva
Recently, the Food and Drug Administration approved the use of the Orbera balloon for obesity treatment. However, the Food and Drug Administration later issued a warning about the possibility of 2 complications not previously reported: acute pancreatitis and balloon hyperinsufflation. This case report is intended to alert all clinicians that, although rare, cases of hyperinsufflation should be considered in patients with an intragastric balloon (IGB) and acute abdomen. IGB removal will resolve the complaints, provided there is no irreversible ischemia of the stomach walls...
2018: ACG Case Reports Journal
Sagarika Satyavada, Perica Davitkov, Meer Akbar Ali, Gregory Cooper, Richard C K Wong, Amitabh Chak
Through-the-scope (TTS) endoscopic Doppler ultrasound probe technology is a tool that has garnered interest for the evaluation of variceal and non-variceal bleeding. In previous studies, this technology has been proposed as a more objective method of identifying the bleeding subsurface blood vessel in peptic ulcer hemorrhage. We describe 3 cases where the use of an endoscopic Doppler probe guided the diagnosis and management of upper gastrointestinal (GI) hemorrhage due to causes other than peptic ulcer disease...
2018: ACG Case Reports Journal
Assad Munis, Brad Solomon, Andrew Mazulis, Timothy Laurie
Pancreaticoduodenectomy, or Whipple procedure, is a high-risk surgical procedure commonly performed for tumors of the pancreatic head. The pancreatico-enteric anastomosis is an important component of this procedure. The maturation and adequate healing of this anastomotic site is critical to decrease the risk of postoperative pancreatic fistulas. The use of stents can help in the healing of this anastomotic site. We present a patient with pancreatic adenocarcinoma who underwent pancreaticoduodenectomy, and presented with progressively worsening lumbar pain 7 years later...
2018: ACG Case Reports Journal
Tooba Tariq, Asad Rizvi, Karun Badwal, Ransome Eke
Spontaneous intramural esophageal rupture (SIER) is a form of acute esophageal trauma defined as an injury deeper than a Mallory-Weiss tear but not extending completely through the muscular propria as in Boerhaave syndrome. SIER is a rare complication of eosinophilic esophagitis (EoE); after extensive literature review, we found 7 case reports of SIER complicating EoE. We present a case of SIER complicating EoE in a 46-year-old man with an atypical presentation requiring endoscopic clipping to achieve successful hemostasis...
2018: ACG Case Reports Journal
Naoto Mizumura, Satoshi Okumura, Hiroshi Tsuchihashi, Masao Ogawa, Masayasu Kawasaki
A 50-year-old man presented with epigastric pain after eating raw mackerel. Abdominal computed tomography revealed submucosal edema of the gastric antrum and pelvic ileum. Gastroscopy revealed an Anisakis simplex in the gastric antrum. His epigastric pain resolved after endoscopic removal of the Anisakis ; however, he developed right lower quadrant pain the following day. Abdominal computed tomography showed submucosal edema of the terminal ileum involving different ileal loops, which was not present on admission...
2018: ACG Case Reports Journal
Talhah Zubair, Timothy Yen, Gordon Gao
Although hepatocellular carcinoma (HCC) recurrence after curative resection is not uncommon, it primarily recurs in the liver prior to metastatic progression. We report a case of resected pT2N0 cryptogenic HCC that recurred in the superior paracervical musculature without evident intrahepatic recurrence. The patient also developed cervical spine instability requiring urgent neurosurgery. Cryptogenic HCC is thought to arise from non-alcoholic fatty liver disease even without cirrhosis. Unfortunately, it also portends a worse prognosis compared to HCC of other etiologies...
2018: ACG Case Reports Journal
Sauid Ishaq, Guled M Jama, Julian Danino, Adrian Hall, Chris J J Mulder, Neil Molony
No abstract text is available yet for this article.
2018: ACG Case Reports Journal
Alexander M Sy, Jogarao Vedula, Iman Hanna, Bhawna Halwan, Patrick Saitta
Cholesterol crystal embolism can be spontaneous or iatrogenic, and it can involve any organ of the gastrointestinal tract, presenting with common gastrointestinal symptoms such as bleeding, perforation, obstruction, and inflammation. It is therefore considered the "great masquerader," requiring a high level of suspicion because the condition is associated with increased morbidity and mortality. We present a 69-year-old man who presented with gastrointestinal bleeding and azotemia. He was found to have cholesterol crystal embolization in the kidney and a duodenal leiomyoma, the latter being an uncommon site to embolize...
2018: ACG Case Reports Journal
Weiguang Qiao, Wen Guo
No abstract text is available yet for this article.
2018: ACG Case Reports Journal
Christienne Shams, Michael Cannon, Jared Bortman, Seifeldin Hakim
A biliary enteric fistula (BEF) is a rare, abnormal communication between any segment of the biliary tree with any portion of the small or large intestine. BEF is more frequently diagnosed with the increasingly widespread use of endoscopic retrograde cholangiopancreatography. Different theories have been postulated regarding the etiology of this fistula formation, with the most likely cause being gallstones. Treatment modalities, ranging from conservative management to surgical reconstruction, show varying levels of success...
2018: ACG Case Reports Journal
Sarah Z Maher, Jayakrishna Chintanaboina, David Eun Kim, Abraham Mathew
Per-oral endoscopic myotomy (POEM) is a relatively novel endoscopic technique for the treatment of achalasia. POEM has been shown to have outcomes comparable to those with Heller myotomy, but it is less invasive and has fewer complications. A 72-year-old man with progressive solid and liquid dysphagia underwent POEM, but soon after the procedure went into cardiac arrest; spontaneous circulation returned after 10 minutes of CPR. He was subsequently found to have tension pneumopericardium as a result of the inadvertent use of air instead of carbon dioxide during the procedure...
2018: ACG Case Reports Journal
Maen Masadeh, Rahman Nakshabendi, Rami El Abiad
No abstract text is available yet for this article.
2018: ACG Case Reports Journal
Joana Carvão, Maria Gorete Faria, Vitor Magno Pereira, Carla Sousa Andrade, Nicodemos Fernandes, José Júlio Nóbrega, Luís Jasmins
Esophageal and gastroduodenal necrosis are rare conditions with poor prognosis. We describe a case that was diagnosed with upper endoscopy in the setting of severe septic shock. To our knowledge, this is the first case in which esophageal and gastroduodenal necrosis occurred simultaneously in this setting. We discuss the pathophysiology, diagnostic approach, and treatment options of this rare entity.
2018: ACG Case Reports Journal
Jingzhou Wang, Arvin Bhatia, Noa Krugliak Cleveland, Nina Gupta, Sushila Dalal, David T Rubin, Atsushi Sakuraba
Secukinumab, an interleukin (IL)-17A antagonist, was associated with disease exacerbations in Crohn's disease, and de novo cases of inflammatory bowel disease (IBD) have been reported in studies of rheumatoid diseases. However, there has been no detailed report demonstrating the linkage between secukinumab therapy and new-onset IBD. We present a unique case of rapid-onset fulminant colitis after receiving 1 dose of secukinumab infusion followed by improvement with combination antibiotics, corticosteroids, and calcineurin inhibition...
2018: ACG Case Reports Journal
Davinia Suárez-Flores, Paulina Moctezuma-Velázquez, Héctor Adrián Díaz-Hernández, Armando Gamboa-Domínguez, Mario Vilatobá-Chapa, Aldo Torre
No abstract text is available yet for this article.
2018: ACG Case Reports Journal
Sridhar Sundaram, Kiran S, Srijan Mazumdar, Akash Shukla
Overlap syndrome indicates the coexistence of 2 or more autoimmune liver diseases in the same individual, occurring simultaneously or sequentially. Cases of overlap of autoimmune hepatitis (AIH) with primary biliary cholangitis (PBC) and of AIH with primary sclerosing cholangitis (PSC) are known and have defined criteria for diagnosis. Overlap between PBC and PSC has been reported in only a few case reports. The cause for the rarity of this entity compared to other overlap syndromes is unclear. We present a case of an overlap syndrome of PBC with PSC in a 35-year-old woman...
2018: ACG Case Reports Journal
Natascha Silva Sandy, Elizete Aparecida Lomazi
Distal intestinal obstruction syndrome (DIOS) is a relatively common intestinal complication in cystic fibrosis (CF), and it can eventually lead to intussusception, a less frequent complication in CF. Intussusception is classically associated with gastrointestinal symptoms that overlap those of DIOS. We describe a young woman with oligosymptomatic intussusception diagnosed after resolution of DIOS symptoms.
2018: ACG Case Reports Journal
Alexander M Sy, Alla Joutovsky, David Friedel
No abstract text is available yet for this article.
2018: ACG Case Reports Journal
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