Signet-Ring Cell Carcinoma Presenting as Hematochezia in a Patient with Crohn ’s Disease
We report a patient with Crohn’s disease who was diagnosed with signet-ring cell carcinoma in the setting of a Crohn’s flare. Diagnosis was made with endoscopy. Treatment included laparoscopic-assisted right hemicolectomy with ileostomy with subsequent chemotherapy as an outpatient .Case Rep Gastroenterol 2019;13:85 –88 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - February 20, 2019 Category: Gastroenterology Source Type: research

Laparoscopic Resection of an Abdominal Wall Metastasis 5 Years after Primary Colorectal Cancer Resection
We report the case of a 65-year-old male with a metachronous abdominal wall metastasis secondary to colorectal cancer. The patient had presented 5 years ago to another facility with a perforated sigmoid colon cancer (pT4a[SE], N0, M0, pStage II), rectal cancer (T2[MP], N0, M0, pStage I), and Fournier gangrene. He had then undergone sigmoidectomy and rectal resection along with S-1 adjuvant chemotherapy. No relapse was observed thereafter. However, currently, 5 years after initial surgery, the patient noticed a palpable mass in the left lower abdomen and was referred to our hospital for further assessment and treatment. Per...
Source: Case Reports in Gastroenterology - February 15, 2019 Category: Gastroenterology Source Type: research

Surgical Laparotomy for Repeated Delayed Arterial Hemorrhage after Pancreaticoduodenectomy
Postpancreatectomy hemorrhage is one of the major life-threatening complications of pancreatic surgery. Radiological intervention is used as a first-line approach for the initial treatment of late arterial hemorrhage. However, rehemorrhage has a high risk for mortality, and it is undecided which urgent intervention provides optimal management for rehemorrhage. We experienced a successful surgical laparotomy for the repeated delayed arterial hemorrhage caused by a pancreaticoduodenectomy (PD) for chronic pancreatitis. A 57-year-old man had undergone PD with pancreaticogastrostomy for tumor-forming pancreatitis with possible...
Source: Case Reports in Gastroenterology - February 14, 2019 Category: Gastroenterology Source Type: research

Primary Gastrointestinal Stromal Tumor of the Liver with Cystic Changes
Gastrointestinal stromal tumors (GISTs) are known to originate specifically from the intestinal cells of Cajal located in the gastrointestinal mesenchyme. GISTs developing outside of the digestive tract have barely been reported. We encountered a first case of large primary GISTs in the liver with cystic changes. A 63-year-old man with a past history of brain infarction visited our hospital. The computed tomography (CT) revealed a 6-cm and a 10-cm mass in the right and the caudal lobe of the liver, respectively. These tumors have marginal enhancement in the arterial phase; however, they presented as hypodense in the intern...
Source: Case Reports in Gastroenterology - February 14, 2019 Category: Gastroenterology Source Type: research

Successful Resection of Solitary Abdominal Wall Metastasis of Sarcomatous Intrahepatic Cholangiocarcinoma
In this report, we present the case of a 75-year-old woman admitted to our hospital with the chief complaint of weight loss. Various imaging techniques demonstrated a single mass in the liver and cecum. A cecal gastrointestinal stromal tumor accompanied by liver metastasis was suspected, and ileocecal resection was performed for diagnostic purposes. However, the tumor was present in the abdominal wall rather than in the cecum. The tumor was resected and diagnosed as undifferentiated sarcoma. We suspected the liver tumor was a series of lesions, so we performed hepatectomy. As the tumor was composed of both adenocarcinoma a...
Source: Case Reports in Gastroenterology - February 14, 2019 Category: Gastroenterology Source Type: research

Rectal Dieulafoy ’s Lesion: A Rare Etiology of Lower Gastrointestinal Hemorrhage
A Dieulafoy ’s lesion is defined as a dilated submucosal vessel that erodes the overlying epithelium without evidence of a primary ulcer or erosion. It is a rare cause of gastrointestinal bleeding that is difficult to identify and subsequently manage. Most commonly, they occur in the upper gastrointestinal tr act, namely the stomach. A Dieulafoy’s lesion of the rectum, however, is an exceedingly rare presentation that can lead to life-threatening gastrointestinal bleeding. Our case consists of an 84-year-old man, who presented with lower gastrointestinal bleeding secondary to a Dieulafoy’s lesion of the r...
Source: Case Reports in Gastroenterology - February 14, 2019 Category: Gastroenterology Source Type: research

Adalimumab Dose-Escalation Therapy Is Effective in Refractory Crohn ’s Disease Patients with Loss of Response to Adalimumab, Especially in Cases without Previous Infliximab Treatment
Conclusions: Adalimumab dose-escalation therapy is effective in refractory Crohn ’s disease patients with loss of response to adalimumab, especially in cases without previous infliximab treatment.Case Rep Gastroenterol 2019;13:37 –49 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - February 6, 2019 Category: Gastroenterology Source Type: research

Endoscopic Retrieval of Mis-Swallowed Table Spoon
Mis-swallowed foreign body is a common scenario for endoscopy intervention. Although a long object is rarely seen in our clinical setting, limited published articles could be found for proper retrieval. We hence report a 30-year-old female who mis-swallowed a long table spoon, which was retrieved by a snare from the duodenal second portion with conventional endoscopy.Case Rep Gastroenterol 2019;13:32 –36 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - January 17, 2019 Category: Gastroenterology Source Type: research

Acute Esophageal Necrosis: A View in the Dark
Acute esophageal necrosis (AEN), also known as Gurvits syndrome, black esophagus, or acute necrotizing esophagitis, is a rare clinical entity and an unusual reason for upper gastrointestinal bleeding. It is typically described in critically ill patients with multiple medical conditions, arising from a combination of ischemic insult to the esophageal mucosa due to low-flow vascular states, corrosive injury caused by reflux of acid and pepsin, and decreased function of the mucosal barrier systems and reparative mechanisms as occurs in malnourished and debilitated physical states. Patients with AEN tend to be older men, as me...
Source: Case Reports in Gastroenterology - January 16, 2019 Category: Gastroenterology Source Type: research

Successful Endoscopic Management of Double Iatrogenic Perforations Induced by Endoscopic Retrograde Cholangiopancreatography and Computed Tomography-Guided Colon Drainage
Endoscopic retrograde cholangiopancreatography (ERCP) is a high-risk procedure with a significantly high rate of complications, such as pancreatitis, bleeding, perforation, and infection. Pancreatitis is the most common post-ERCP complication with an incidence of approximately 3.5%. Although perforation is a rare complication with an incidence of 0.1 –0.6%, it may be associated with a high rate of mortality of 1.0–1.5%. Here, we report a rare case of ERCP-induced double iatrogenic perforations in the duodenum and colon complicated by an intra-abdominal abscess. The post-ERCP perforation was successfully sealed ...
Source: Case Reports in Gastroenterology - January 13, 2019 Category: Gastroenterology Source Type: research

Splenic Injury with Subsequent Pleural Effusion: An Underreported Complication of Colonoscopy
We present a case in which a previously healthy 59-year-old female developed a splenic injury and later pleural effu sion after screening colonoscopy.Case Rep Gastroenterol 2019;13:6 –11 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - January 13, 2019 Category: Gastroenterology Source Type: research

Duodenal Ulceration following Holmium Laser Lithotripsy
The epidemiology of peptic ulcer disease (PUD) has changed considerably in the last several decades. Previously a chronic disease characterized by frequent recurrences with a high rate of surgical interventions, it is now largely a self-limited disease that is medically managed. The role of acid suppression was widely recognized as being important in the pathogenesis of PUD in the 19th century, while it was not until the 1980s and 1990s that the importance ofHelicobacter pylori infection was identified. Today, PUD is largely caused by eitherH. pylori infection or nonsteroidal anti-inflammatory drug use. However, other less...
Source: Case Reports in Gastroenterology - January 13, 2019 Category: Gastroenterology Source Type: research

Metachronous Sigmoid Carcinoma and Mantle Cell Lymphoma in Intestines
It is rare that colon carcinoma and mantle cell lymphoma (MCL) occur one after another in intestines. We found two malignancies of sigmoid carcinoma and MCL in a single patient, who had initially been diagnosed with sigmoid carcinoma and treated with radical resection in our hospital. Good postoperative recovery was reported without recurrence signs, which lasted for 7 years and 5 months until polyps of sigmoid colon were found by colonoscopy. Biopsy and immunohistochemistry revealed MCL, but the patient refused treatment. One year later, MCL was diagnosed again in the transverse colon. The patient is currently under obser...
Source: Case Reports in Gastroenterology - January 13, 2019 Category: Gastroenterology Source Type: research

Adenosquamous Carcinoma of the Choledochus
The patient was an 86-year-old man who was admitted with obstructive jaundice. Computed tomography revealed a tumor in the hilar choledochus with peripheral hepatic duct dilatation. Endoscopic cholangiography (ERC) demonstrated the defect in the choledochus. Brushing cytology during ERC showed Orange-G-philic keratinized atypical cells, which led to a diagnosis of squamous cell carcinoma. Chemotherapy with tegafur-gimeracil-oteracil potassium was ineffective and was discontinued due to adverse effects. The patient died 5 months after the diagnosis and autopsy revealed tubular adenocarcinoma of the hilar bile duct with squa...
Source: Case Reports in Gastroenterology - January 4, 2019 Category: Gastroenterology Source Type: research

Pulse Granulomas in Interval Appendectomy Specimens: Histochemical Identification of Cellulose Matter
This report presents histopathologic findings of pulse granuloma lesions observed in two appendectomy cases, with some histochemical examinations of cellulose matter which is reportedly a major component to provoke pulse granuloma reaction. Our patients in both cases were girls in their teens, and they underwent interval appendectomy for acute appendicitis. Both appendectomy specimens revealed ruptured walls with inflammatory granulation tissue with marked foreign body reaction including characteristic collections of ring-like, curled ribbon-like, and/or lobulated nephrosclerosis-like hyaline structures and various foreign...
Source: Case Reports in Gastroenterology - December 20, 2018 Category: Gastroenterology Source Type: research

Laparoscopic Excisional Cholecystectomy with Full-Thickness Frozen Biopsy in Suspected Gallbladder Carcinoma
Owing to the advantages of a laparoscopic approach, laparoscopic cholecystectomy (LC) is thought to be the treatment of choice in gallbladder disease, even in cases of suspected malignancy. However, it is difficult to differentiate between cholecystitis and gallbladder carcinoma (GBC). We performed radical hepatectomy in patients with pT2 GBC diagnosed by full-thickness frozen biopsy. A 75-year-old Japanese man presented to our hospital with discomfort in the right upper quadrant of the abdomen. This patient was diagnosed with suspected GBC and was scheduled to undergo LC and intraoperative histological examination. Follow...
Source: Case Reports in Gastroenterology - December 13, 2018 Category: Gastroenterology Source Type: research

Idiopathic Pan-Colonic and Small-Intestine Varices
Idiopathic colonic varices represent a rare source of gastrointestinal haemorrhage with a presumed incidence around 0.0007%. Herein, we present a case of idiopathic colonic and small-intestine varices. According to our knowledge, this case report is the first description of both pan-colonic and small-intestine idiopathic varices of this extent. A young male patient without any previous notable medical history was admitted to the hospital because of massive enterorrhagia with haemodynamic instability. Colonoscopy revealed massive pan-colonic varices. After stabilization, numerous diagnostic procedures were performed in orde...
Source: Case Reports in Gastroenterology - December 13, 2018 Category: Gastroenterology Source Type: research

Incidentally Detected Amyloid Light-Chain Amyloidosis Caused by Monoclonal Gammopathy of Undetermined Significance: Possible Time-Dependent Change in Colonic Findings
Amyloid light-chain (AL) amyloidosis is associated with plasma cell disorder and monoclonal light chains. This type of amyloidosis is the prominent type involving the gastrointestinal tract. Monoclonal gammopathy of undetermined significance (MGUS) is the most common plasma cell disorder and a known precursor of more serious diseases. A 72-year-old male was treated for high blood pressure, diabetes, and gout at the clinic of a private physician. Due to a positive fecal occult blood test discovered during colon cancer screening, he underwent colonoscopy and was diagnosed with adenomatous polyps by biopsies. Two months later...
Source: Case Reports in Gastroenterology - December 6, 2018 Category: Gastroenterology Source Type: research

Successful Endoscopic Closure Using Polyglycolic Acid Sheets with Fibrin Glue for Nonhealing Duodenal Ulcer with Perforation after Proton Beam Therapy of Liver Tumor
We describe the first case of a nonhealing duodenal ulcer with perforation after proton beam therapy (PBT) of a liver tumor that was successfully treated endoscopically using polyglycolic acid (PGA) sheets with fibrin glue. A 69-year-old man received PBT for a liver tumor. Esophagogastroduodenoscopy (EGD) 3 months after PBT revealed a duodenal ulcer. A proton pump inhibitor was administered for 7 weeks, and the ulcer healed. Six months after the EGD, recurrence of the duodenal ulcer with perforation occurred. An emergency open surgery with placement of the omental patch was performed. However, 5 days after the surgery, bec...
Source: Case Reports in Gastroenterology - November 28, 2018 Category: Gastroenterology Source Type: research

Intrabiliary Migrated Clips and Coils as a Nidus for Biliary Stone Formation: A Rare Complication following Laparoscopic Cholecystectomy
In conclusion, surgical clips and coils can migrate into the biliary tract and serve as a nidus for the formation of bile duct stones. Although rare, this complication should caution surgeons not to place clips “at random” during cholecystectomy. Patients with this rare complication are best managed by ERCP in combination with sphincterotomy and stone extraction.Case Rep Gastroenterol 2018;12:686 –691 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - November 28, 2018 Category: Gastroenterology Source Type: research

Gastric Outlet Obstruction due to Intramural Duodenal Hematoma after Endoscopic Biopsy: Possible Therapeutic Role of Endoscopic Dilation
We describe a 28-year-old healthy male who presented with acute abdominal pain a few hours after a routine esophagogastrodudenoscopy with biopsies was performed. Following an otherwise uneventful endoscopy, he developed a gastric outlet obstruction and pancreatitis secondary to an IDH. The patient was managed conservatively. Resolution of his gastric outlet obstruction occurred immediately after gentle passage of the endoscope through the narrowed duodenal lumen.Case Rep Gastroenterol 2018;12:692 –698 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - November 28, 2018 Category: Gastroenterology Source Type: research

Spontaneous Remission of Diffuse Large B Cell Lymphoma in the Stomach and the Continuation of Remission for 10 Years
According to the literature, spontaneous remission of aggressive lymphomas is extremely rare; gastric non-Hodgkin lymphomas, such as mucosa-associated lymphoid tissue lymphomas, often regress due toHelicobacter pylori treatment or no progression, even in a watch-and-wait strategy. Although spontaneous remission of diffuse large B cell lymphomas in the stomach was very rarely reported, the follow-up periods of the cases of spontaneous remission are within 2 years and most cases are likely to relapse after the first remission. Here, we report that a diffuse large B cell lymphoma in the stomach showed spontaneous remission wi...
Source: Case Reports in Gastroenterology - November 28, 2018 Category: Gastroenterology Source Type: research

Severe Diarrhea in the Setting of Immune Checkpoint Inhibitors
We present a case of microscopic colitis diagnosed after the initiation of nivolumab and a case of ipilimumab colitis andClostridium difficile in the setting of Crohn ’s colitis.Case Rep Gastroenterol 2018;12:704 –708 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - November 28, 2018 Category: Gastroenterology Source Type: research

A Rare Cause of Abdominal Pain in Adults: Meckel ’s Diverticulitis
A 42-year-old man presented to the emergency room with complaints of periumbilical abdominal pain. A contrast-enhanced computed tomography revealed mucosal thickening in the small bowel of the right abdomen. There was a fairly large small bowel diverticulum associated with this segment. Findings were suggestive of small bowel diverticulitis or possibly focal enteritis. A Meckel ’s diverticulum scan was diagnostic of Meckel’s diverticulum. The patient was then immediately taken to the operating room for emergency laparotomy and was intra-operatively found to have a thickened Meckel’s diverticulitis with ad...
Source: Case Reports in Gastroenterology - November 28, 2018 Category: Gastroenterology Source Type: research

Collision Tumor of Adenocarcinoma and Gastrointestinal Stromal Tumor in the Small Bowel
We report a very rare case of collision tumor composed of primary adenocarcinoma of the jejunum and gastrointestinal stromal tumor (GIST). The patient was a 63-year-old man who visited our hospital for epigastralgia and vomiting. Abdominal computed tomography revealed a mass in the upper jejunum, with gastric and duodenal dilatation. Endoscopy of the small bowel showed a circumferential tumor in the upper jejunum, which was diagnosed as primary adenocarcinoma by tissue biopsy. Thereafter, partial resection of the small bowel from the third part of the duodenum over the upper jejunum was performed. A tumor colliding with th...
Source: Case Reports in Gastroenterology - November 28, 2018 Category: Gastroenterology Source Type: research

Endoscopic Ultrasound-Guided Gallbladder Drainage for Aberrant Right Posterior Duct Obstruction Developing after Placement of a Covered Self-Expandable Metallic Stent in a Patient with Distal Biliary Obstruction
We present a case of successful EUS-GBD for malignant obstruction of an aberrant hepatic duct draining directly into the cystic duct.Case Rep Gastroenterol 2018;12:722 –728 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - November 28, 2018 Category: Gastroenterology Source Type: research

Whole Genome Sequencing Analysis of a Stage IV Colon Cancer Patient with a 10-Year Disease-Free Survival following Systemic Chemotherapy/Bevacizumab
It is rare that stage IV colon cancer is cured with chemotherapy. Here we report the long-term survival of a patient who presented with highly advanced disease characterized by a papillary architecture as well as porta hepatis lymph nodes but responded extremely well to FOLFIRI/bevacizumab. His original tumor underwent comprehensive genomic testing that included whole genome DNA sequencing, targeted sequencing, and RNA sequencing. These genetic results suggest the patient ’s tumor harbored mutations inAPC,KRAS, andTP53 as well as inPIK3CB. Moreover, the RNA-seq data suggested that the tumor belonged to the consensus ...
Source: Case Reports in Gastroenterology - November 28, 2018 Category: Gastroenterology Source Type: research

An Extragastrointestinal Stromal Tumor Originating from the Pancreas
We report a case of GIST arising in the pancreas that was confirmed by surgical resection.Case Rep Gastroenterol 2018;12:671 –678 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - November 22, 2018 Category: Gastroenterology Source Type: research

Long-Term Cholic Acid Treatment in a Patient with Zellweger Spectrum Disorder
Zellweger spectrum disorders (ZSDs) are a subgroup of peroxisomal biogenesis disorders with a generalized defect in peroxisome function. Liver disease in ZSDs has been associated with the lack of peroxisomal β-oxidation of C27-bile acid intermediates to form primary C24-bile acids, which prevents normal physiologic feedback and leads to accumulation of hepatotoxic bile acid intermediates. Primary bile acid therapy, oral cholic acid (CA), as adjunctive treatment for ZSDs, restores physiologic feedback inhibition on bile acid synthesis and inhibits formation of hepatotoxic bile acid intermediates. Our patient is a Cauca...
Source: Case Reports in Gastroenterology - November 21, 2018 Category: Gastroenterology Source Type: research

Erratum
Case Rep Gastroenterol 2018;12:660 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - November 20, 2018 Category: Gastroenterology Source Type: research

Giant Left-Sided Amyand ’s Hernia: A Challenging Procedure in a Rural Hospital
The finding of a vermiform appendix in the case of an inguinal hernia that extends below the midpoint of the inner thigh when the patient is in a standing position is defined as giant left-sided Amyand ’s hernia. It is a very rare case and significantly challenging in terms of preoperative diagnosis and surgical management. Here we present our experience with a case of a giant left-sided Amyand’s hernia that was followed up for 2 months.Case Rep Gastroenterol 2018;12:646 –652 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - November 14, 2018 Category: Gastroenterology Source Type: research

Spontaneous Pathological Complete Regression of Hepatocellular Carcinoma
We describe a case of spontaneous pathological complete regression of HCC following decrement of elevated serum AFP. Further studies are needed to identify the mechanism(s) of spontaneous regression of HCC.Case Rep Gastroenterol 2018;12:653 –659 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - November 14, 2018 Category: Gastroenterology Source Type: research

A Rare Cause of Dysphagia and Weight Loss
We report the case of a patient who presented with dysphagia, 25-lb weight loss, difficulty opening her mouth, and joint pain. Dysphagia workup showed a normal barium swallow and normal-appearing EGD but esophageal manometry consistent with severe dysmotility. Through further laboratory and imaging studies, the patient met the diagnostic criteria for MCTD. She had marked improvement in her dysphagia with steroids, biologic therapy, and intravenous immunoglobulin.Case Rep Gastroenterol 2018;12:640 –645 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - November 1, 2018 Category: Gastroenterology Source Type: research

A Successfully Treated Case of Intrahepatic Cholangiocarcinoma with Exacerbation of Dermatomyositis
Dermatomyositis (DM) is often found in conjunction with malignant tumors such as lung, cervical, and breast cancer. However, the association with intrahepatic cholangiocarcinoma (ICC) is extremely rare. Moreover, to our knowledge, there have been no previous reports of DM discovered because of exacerbation of DM. Our case was a 44-year-old female with dry cough, myalgia, and arthralgia. We performed hepatic resection for intrahepatic ICC. She was diagnosed with DM, and combination treatment with prednisolone and tacrolimus was started. During outpatient visits, her symptoms worsened, and she was hospitalized due to deterio...
Source: Case Reports in Gastroenterology - October 24, 2018 Category: Gastroenterology Source Type: research

Successful Treatment of Hepatitis C Virus by Ledipasvir/Sofosbuvir in a Cirrhotic Patient with Sickle Cell Disease and Thalassemia Minor
Around 8% of patients diagnosed with sickle cell disease (SCD) are hepatitis C virus (HCV) carriers. Previously, HCV treatment was seldom considered in SCD patients, as the ribavirin-induced hemolysis and interferon-induced cytopenias could lead to more profound anemia. Nowadays, several oral direct-acting antiviral drugs have been developed and approved by the FDA for hepatitis C treatment. While direct-acting antivirals mitigate many of these risks, their safety and efficacy in SCD patients remains insufficiently explored. Here, we report on successfully treating HCV with ledipasvir/sofosbuvir in a compensated cirrhotic ...
Source: Case Reports in Gastroenterology - October 24, 2018 Category: Gastroenterology Source Type: research

< b > < i > Clostridium difficile < /i > < /b > Causing Empyema
We present a 42-year-old Hispanic male withC. difficile empyema without any prior history of CDI.Case Rep Gastroenterol 2018;12:633 –639 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - October 24, 2018 Category: Gastroenterology Source Type: research

Anti-TNF Exposure during Pregnancy in Crohn ’s Disease Patients
This study aimed to describe the management of 4 Crohn ’s disease patients who received anti-TNF therapy during pregnancy and present a literature review. We reported 4 cases composed of young women who became pregnant while receiving anti-TNF agents. The patients presented a satisfactory response to the clinical treatment and the pregnancies progress ed without complications. We did not observe maternal or embryonic toxicity, or unfavorable outcomes. The available data point to inflammatory activity as the main risk factor for unfavorable gestational evolution to date, and showed anti-TNF therapy to be safe during p...
Source: Case Reports in Gastroenterology - October 17, 2018 Category: Gastroenterology Source Type: research

Severe de novo Ulcerative Colitis following Ixekizumab Therapy
We report a unique case of severe new-onset ulcerative colitis in a young male complicated by cytomegalovirus infection who was on ixekizumab therapy for plaque psoriasis. We recommend that clinicians should exercise caution before prescribing ixekizumab as it seems to induce and exacerbate IBD.Case Rep Gastroenterol 2018;12:617 –621 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - October 17, 2018 Category: Gastroenterology Source Type: research

Erratum
Case Rep Gastroenterol 2018;12:586 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - October 5, 2018 Category: Gastroenterology Source Type: research

Alveolar Echinococcosis Mimicking a Hepatic Neoplasm with Lymph Node Metastasis: A Case Report
A 37-year-old man had an asymptomatic 17-mm mass in the liver by health check with ultrasonography. Five years later, he was referred to our hospital because the mass was slightly enlarged with a peripancreatic lymph node. We performed endoscopic ultrasonography fine-needle aspiration (EUS-FNA) to evaluate a lymph node, but it showed amorphous eosinophilic material and eosinophilic infiltrate in necrotic tissue of toothpaste-like white specimen. However, we diagnosed as potentially malignant liver mass with lymph node metastasis because of 2-deoxy-2-(fluorine-18) fluorodeoxyglucose uptake. We then performed hepatectomy and...
Source: Case Reports in Gastroenterology - October 5, 2018 Category: Gastroenterology Source Type: research

Secondary Adrenal Insufficiency after Treatment with Budesonide for Autoimmune Hepatitis
Autoimmune hepatitis (AIH) is a rare cause of chronic liver disease. The backbone of treatment is immunosuppressive medication, typically prednisolone as induction therapy and azathioprine as a maintenance therapy. Side effects of the long-term use of systemic corticosteroids are well known and have led to the use of alternative induction regimens. An attractive alternative is budesonide, a nonhalogenated glucocorticosteroid characterized by a high first-pass effect in the liver (90%), resulting in a high topical anti-inflammatory activity and a low systemic activity. It should be stressed that budesonide is contraindicate...
Source: Case Reports in Gastroenterology - October 5, 2018 Category: Gastroenterology Source Type: research

Overstaged Rectal Cancer by MRI due to Fibrosis Induced by Tattoo Marker
We describe a case of cT stage overestimation due to fibrosis of the rectal wall and perirectal fat, induced by carbon-based dye injection in a 66-year-old patient. In our case it was an overestimation of MR evaluation in the case of early invasive carcinoma. Although there have been some studies on tissue effect of carbon-based dyes, the possible scenario consequence of cancer stage overestimation due to fibrosis has not yet been described. Such a mistake could lead to inappropriate overtreatment. Clinicians must be aware of the possible consequences of dye injection and resultant overestimation of T stage of colorectal c...
Source: Case Reports in Gastroenterology - October 5, 2018 Category: Gastroenterology Source Type: research

Repeated Plastic Stentings of Common Hepatic Duct for Portal Vein Aneurysm Compression in a Patient Unsuitable for Surgery
We describe an 85-year-old man who presented with abdominal pain and low-grade fever with clinical signs consistent with cholangitis. Endoscopic retrograde cholangiopancreatography revealed a common hepatic duct stricture and concomitant intraductal ultrasonography identified adjacent aneurysmal portal vein dilatation. The final diagnosis of portal vein aneurysm was made using contrast computerized tomography scan. The patient was considered unsuitable for surgery due to his advanced age and multiple comorbidities. Instead, an endoscopic biliary plastic stent was inserted as a therapeutic alternative, which successfully ac...
Source: Case Reports in Gastroenterology - September 20, 2018 Category: Gastroenterology Source Type: research

A Highly Advanced Gastric Cancer Maintaining a Clinical Complete Response after Chemoradiotherapy Comprising S-1 and Cisplatin
We report a patient with highly advanced gastric carcinoma who was treated successfully with chemoradiotherapy (CRT) comprising S-1 and cisplatin. The patient was a 71-year-old male who was diagnosed with advanced gastric carcinoma by esophagogastroduodenoscopy (EGD) by medical examination. EGD demonstrated type 3 advanced gastric carcinoma in the posterior wall of the upper gastric body. An abdominal computed tomography (CT) scan showed that the gastric wall was thickened due to gastric primary tumor, and large lymph nodes (LNs) including the lesser curvature LN, anterosuperior LN along the common hepatic artery and some ...
Source: Case Reports in Gastroenterology - September 20, 2018 Category: Gastroenterology Source Type: research

Appendiceal Perforation due to Migration of a Dental Instrument
We report a patient with appendiceal perforation due to a foreign body (dental instrument for root canal treatment) in the appendix.Case Rep Gastroenterol 2018;12:551 –555 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - September 18, 2018 Category: Gastroenterology Source Type: research

Angiotensin-Converting Enzyme Inhibitor-Induced Gastrointestinal Angioedema: The First Danish Case Report
Angiotensin-converting enzyme inhibitors (ACEI) are widely used to treat hypertension and congestive heart failure. A rare side effect of ACEI therapy is angioedema, which in very rare cases may present as gastrointestinal angioedema (GA). A 45-year-old female presented with suddenly occurring diffuse abdominal pain. Imaging studies revealed small bowel wall edema. The patient had been on ACEI therapy for the last 6 months. The therapy was withdrawn, and the patient recovered quickly. There is no specific diagnostic test to confirm ACEI-induced GA, but symptoms usually regress completely after therapy discontinuation. An e...
Source: Case Reports in Gastroenterology - September 18, 2018 Category: Gastroenterology Source Type: research

Small-Bowel Obstruction Secondary to Ileal Trichobezoar in a Patient with Rapunzel Syndrome
Bezoars are conglomerations of undigested foreign material retained in the gastrointestinal tract. Trichobezoar is a compact conglomeration of swallowed hair and constitutes less than 6% of all bezoars. Their most frequent location is in the stomach but they may extend through the pylorus into the small bowel. This condition is known as Rapunzel syndrome. Many patients may remain asymptomatic or present a mild form of the disease characterized by abdominal pain, early satiety, nausea, and vomiting. Complications may manifest as gastric outlet obstruction or bleeding, and intestinal obstruction. A 15-year-old female patient...
Source: Case Reports in Gastroenterology - September 18, 2018 Category: Gastroenterology Source Type: research

Acute Abdomen with Ileus: A Heralding Presentation of Neuroleptic Malignant Syndrome
The pathophysiology of neuroleptic malignant syndrome (NMS) with use of psychotropic drugs is still unclear. Although a rare event with an incidence of 0.02 –3.2%, when not promptly recognized and managed, it carries a high mortality (10–20%) and morbidity rate. Presentation can be either typical, with muscle rigidity and hyperpyrexia, or atypical, the latter posing diagnostic and early management challenges in clinical practice. Our patient present ed with delayed fever and ileus, making early diagnosis difficult. We propose that NMS be considered an alternate diagnosis in patients using psychotropic medicatio...
Source: Case Reports in Gastroenterology - September 18, 2018 Category: Gastroenterology Source Type: research

Simultaneous Resection for Synchronous Double Primary Cancers of the Pancreas and the Liver
In conclusion, we describe 2 cases of hepato-pancreatectomy for synchronous double primary cancers of the pancreas and the liver, where exclusion of the liver tumor as a metastatic lesion from the pancreatic cancer is important.Case Rep Gastroenterol 2018;12:504 –512 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - September 2, 2018 Category: Gastroenterology Source Type: research

Arterial Pseudoaneurysm within a Pancreatic Pseudocyst
The formation of pancreatic pseudocysts and (pseudo-)aneurysms of intestinal vessels are rare but life-threatening complications in acute and chronic pancreatitis. Here we report the rare case of a patient suffering from chronic pancreatitis with an arterial pseudoaneurysm within a pancreatic pseudocyst and present its successful therapeutic management by angioembolization to prevent critical bleeding. A 67-year-old male with a history of chronic pancreatitis presented with severe acute abdominal pain and vomiting to the emergency department. Seven weeks prior to the present admission, a CT scan had displayed a pancreatic ...
Source: Case Reports in Gastroenterology - September 2, 2018 Category: Gastroenterology Source Type: research