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ACG Case Reports Journal

Jagpal S Klair, Kaartik Soota, Aditi Vidholia, Caryn M Berkowitz
No abstract text is available yet for this article.
2018: ACG Case Reports Journal
Nicolette J Rodriguez, Neil Gupta, Joanna Gibson
Autoimmune enteropathy is a rare but severe disorder with significant immune-mediated changes. We present a 54-year-old woman with history of refractory ulcerative colitis status post total colectomy with end ileostomy who presented 1 month after her surgery with high ostomy output of 4 L/d. After a negative workup, ileoscopy with biopsies showed severe chronic active ileitis. Enteroscopy revealed diffuse chronic enteritis concerning for autoimmune enteropathy. She was started on budesonide and intravenous solumedrol, but her ostomy output remained high...
2018: ACG Case Reports Journal
Sarah R Lieber, Norman Ettenger, Steven A Atlas
Dysphagia and cough in an older male smoker raise concern for malignancy. However, a history of environmental exposures led to a much more interesting diagnosis in this case of pneumoconiosis due to silicosis. Silicosis is an uncommon pulmonary disease with rare associated gastrointestinal symptoms. We report a bronchoesophageal fistula resulting from silicosis causing dysphagia and cough. This is the first report of using endoscopic stenting to manage an esophageal fistula from silicosis. This case highlights how common symptoms of cough and dysphagia can masquerade as a pulmonary or oropharyngeal problem, when they are actually gastrointestinal manifestations of a rare disease...
2018: ACG Case Reports Journal
V V Pavan Kedar Mukthinuthalapati, Bashar Attar, Hemant Mutneja, Moinuddin Syed, Seema Gandhi
A 53-year-old man presented with melena 3 months after microwave ablation of a renal mass. Esophago-gastroduodenoscopy and radiological imaging revealed that a fistulous tract extended from the duodenum to the right kidney. The patient had a hemorrhage that originated from a branch of the renal artery and bled through the fistulous tract into the duodenal lumen. Angiography was used in the successful coiling of the bleeding vessel to control the bleeding. Consideration of a fistulous tract as a source of gastrointestinal bleeding should be included in a clinician's differential diagnosis when dealing with patients who had a recent ablative procedure...
2018: ACG Case Reports Journal
Edward Krajicek, Stuart Sherman, Marco Lacerda, Matthew S Johnson, Raj Vuppalanchi
Hepatic artery thrombosis is a concerning complication of orthotopic liver transplantation, and it most often occurs early in the posttransplant period. However, on rare occasions it can occur at a time remote from transplant. We present a case of ischemic cholangiopathy complicated by stricture and anastomotic bile leak from chronic hepatic artery thrombosis that occurred 11 years after the transplant. The initial biliary stenting helped with the resolution of the leak but she was found to have stones, sludge and copious pus at the time of stent exchange...
2018: ACG Case Reports Journal
Ahmed I Edhi, Mitchell S Cappell, Nisha Sharma, Mitual Amin, Atulkumar Patel
No abstract text is available yet for this article.
2018: ACG Case Reports Journal
Ahmed Kamal, Ayman Hafez Youssef, Amal Refaat Mansour
Many cases have been reported about the role of chronic hepatitis C and interferon therapy in the development and recurrence of thrombotic thrombocytopenic purpura (TTP), but to our knowledge there is no previous report about the association between acute hepatitis C and any microangiopathic hemolytic anemia (MAHA) including TTP. We report a case of acute hepatitis C that presented with MAHA resembling TTP, which resolved with spontaneous clearance of viral infection.
2018: ACG Case Reports Journal
Marcus Esteban, Jaimin Amin, Martin Hertl, Shriram Jakate, Ajaypal Singh
Biliary adenofibroma and hepatobiliary mucinous cystic neoplasm are exceedingly rare tumors. To our knowledge, no case of co-existent biliary adenofibroma and mucinous cystic neoplasm has been previously reported. We present a patient who was diagnosed with both tumors concurrently. Both can present with abdominal pain, although some are diagnosed incidentally in asymptomatic patients. Imaging and tumor markers can be suggestive, but histologic examination is needed for definitive diagnosis. Both have a propensity for malignant transformation, thus complete surgical resection is the treatment of choice...
2018: 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
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