Peritoneal < b > < i > Chlamydia trachomatis < /i > < /b > Infection as a Cause of Ascites: A Diagnosis Not to Be Missed
We report a 36-year-old patient presenting with abdominal swelling for a week prior to hospitalization. An extensive workup excluded liver or heart disease and malignancy. A computed tomography scan demonstrated massive ascites and severe thickening of peritoneal reflections. Laboratory tests showed low serum-ascites albumin gradient, high total protein, and low adenosine. Diagnostic laparoscopy revealed inflammatory signs of both fallopian tubes. The histopathological results from peritoneal biopsy were consistent with lymphoid proliferation with reactive lymphoplasmacytic infiltrate. A gynecological investigation showed ...
Source: Case Reports in Gastroenterology - October 11, 2021 Category: Gastroenterology Source Type: research
Nasobiliary Drain Diverted through a Percutaneous Endoscopic Gastrostomy Tube: A Novel Approach to Nasobiliary Drainage
Intractable pruritus is a common, debilitating symptom and a well-defined entity occurring in chronic cholestatic disorders. Treatment options include cholestyramine, rifampicin, naltrexone, gabapentin, and sertraline, as well as more interventional measures, such as plasmapheresis, extracorporeal albumin dialysis, nasobiliary drains (NBDs), and UVB phototherapy in patients who fail to respond to medical therapy. Despite the limited data, NBD seems to be a highly effective treatment in the relief of refractory cholestatic pruritus. In this article, we present the case of a 73-year-old woman with primary biliary cholangitis...
Source: Case Reports in Gastroenterology - October 7, 2021 Category: Gastroenterology Source Type: research
First Report of Fulminant Budd-Chiari Syndrome Treated by Direct Intrahepatic Portocaval Shunt in Vietnam
We described a case of a 21-year-old male with fulminant hepatic failure owning to BCS with a 4-day history of abdominal pain and nausea. Laboratory workup, including viral, autoimmune etiologies JAK2 mutation, Factor V Leiden, antiphospholipid antibody syndrome, was negative. The patient ’s clinical status worsened with hepatic encephalopathy stage II despite administering anticoagulation. Thus, the patient underwent urgently DIPS after unaccessible to the creation of a transjugular intrahepatic portosystemic shunt and impossible to transplantation. The patient’s health was impr oved and discharged. Fulminant Budd-Chi...
Source: Case Reports in Gastroenterology - September 30, 2021 Category: Gastroenterology Source Type: research
Duodenal and Biliary Obstruction due to Extrinsic Compression by Recurrent Lobular Breast Carcinoma: A Case Report
We report a case of abdominal recurrence of ILC of the breast causing intra-abdominal contracture leading to extrinsic compression of the duodenum and periampullary biliary tree. Four years after the patient ’s diagnosis of a left breast pT1c, pN2, cM0 invasive lobular breast cancer, she presented with liver function tests consistent with biliary obstruction, and there was concern for a periampullary malignancy. Definitive diagnosis was achieved at laparotomy. This case demonstrates the importance of considering metastatic breast cancer as a potential cause of GI symptoms and radiological abnormalities affecting any part...
Source: Case Reports in Gastroenterology - September 30, 2021 Category: Gastroenterology Source Type: research
Duodenal and Biliary Obstruction due to Extrinsic CompressionDuodenal and Biliary Obstruction due to Extrinsic Compression by Recurrent Lobular Breast Carcinoma: A Case Report
We report a case of abdominal recurrence of ILC of the breast causing intra-abdominal contracture leading to extrinsic compression of the duodenum and periampullary biliary tree. Four years after the patient ’s diagnosis of a left breast pT1c, pN2, cM0 invasive lobular breast cancer, she presented with liver function tests consistent with biliary obstruction, and there was concern for a periampullary malignancy. Definitive diagnosis was achieved at laparotomy. This case demonstrates the importance of considering metastatic breast cancer as a potential cause of GI symptoms and radiological abnormalities affecting any part...
Source: Case Reports in Gastroenterology - September 30, 2021 Category: Gastroenterology Source Type: research
Sodium Polystyrene Sulfonate-Induced Gastric Pneumatosis: A Rare Side Effect
We present a unique case report of gastric pneumatosis as a complication of kayexalate.Case Rep Gastroenterol 2021;15:862 –867 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - September 30, 2021 Category: Gastroenterology Source Type: research
Idiopathic Esophageal Lipomatosis: An Incidental Benign Discovery
We report the case of an 86-year-old man with multiple medical comorbidities who was admitted to our hospital for community-acquired pneumonia. Computed tomography angiography of his pulmonary arteries ruled out the possibility of pulmonary embolism but showed a 9-mm circumferential wall thickening in the proximal esophagus measuring −172 HU, which is similar in opacity to the adipose tissue. The patient was asymptomatic and without any current or prior symptoms of dysphagia or odynophagia. The barium esophagogram was unremarkable; there were no strictures, masses, or mucosal abnormalities. There was no evidence of esoph...
Source: Case Reports in Gastroenterology - September 30, 2021 Category: Gastroenterology Source Type: research
A Rare Cause of Acute Abdomen in a 59-Year-Old Male
Celiac artery dissection is often an inconspicuous cause of acute abdomen. Spontaneous celiac artery dissection is most often associated with aortic dissection, and thus isolated spontaneous celiac artery dissection is rare. Herein, we present a case of celiac artery dissection with no aortic involvement. This case emphasizes the importance of including such a condition in the differential diagnosis of patients presenting with acute abdomen.Case Rep Gastroenterol 2021;15:852 –855 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - September 29, 2021 Category: Gastroenterology Source Type: research
Successful Surgical Intervention of Strangulated Ileus with a Simple Cut of the External Iliac Vein without Vein Reconstruction
A 67-year-old woman with epigastralgia was referred to our hospital. The patient had undergone hysterectomy, bilateral oophorectomy, omentectomy, and radical pelvic and para-aortic lymph node dissection for her ovarian cancer 6 years before. Despite the gastrointestinal decompression therapy under the presumed diagnosis of adhesive ileus, computed tomography scans taken 3 days after the onset of epigastralgia showed marked dilatation of the small intestine and an oval high-density mass, that is, thrombi, in the right femoral vein. Aggravation of ileus with the thrombi in the femoral vein made us to treat the patient with s...
Source: Case Reports in Gastroenterology - September 29, 2021 Category: Gastroenterology Source Type: research
A Japanese Patient with Gaucher Disease Treated with the Oral Drug Eliglustat as Substrate Reducing Therapy
We report here the case of a 31-year-old male Japanese patient with Gaucher disease who switched from enzyme replacement therapy (ERT) to substrate reducing therapy (SRT). Liver dysfunction was identi fied at a routine medical checkup, and the patient was referred to our hospital with “idiopathic liver disease.” Clinical laboratory tests indicated thrombocytopenia and splenomegaly, which are characteristic symptoms of Gaucher disease. To definitively diagnose Gaucher disease, a bone marrow bi opsy and acid β-glucosidase activity measurement were conducted; the results supported a diagnosis of Gaucher disease. This cas...
Source: Case Reports in Gastroenterology - September 28, 2021 Category: Gastroenterology Source Type: research
Multiple Esophageal Leiomyoma Presenting with Clinical Dysphagia from Mechanical Obstruction and Motility Disorder
We report a rare case of numerous esophageal leiomyomas which caused dysphagia as a result of both mechanical obstruction and hypomotility disorder. The histopathology confirmed the diagnosis of esophageal leiomyoma. Symptoms improved significantly after lifestyle modifications and adherence to dietary advice on the part of the patient.Case Rep Gastroenterol 2021;15:838 –845 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - September 27, 2021 Category: Gastroenterology Source Type: research
Gastrointestinal Stromal Tumor Associated with Neurofibromatosis Type 1 Simulating a Neurofibrosarcoma in a Black African Adult Patient
Gastrointestinal stromal tumor (GIST) is the most prevalent mesenchymal tumor encountered in patients with neurofibromatosis type I (NF1). This association is rarely reported in black African adult patients. Clinical signs such as abdominal pain, intestinal bleeding, and palpable abdominal nodules may contribute to the diagnosis of GIST. However, these clinical signs may also indicate the presence of other solid intestinal tumors such as a neurofibrosarcoma which is an intestinal complication of NF1. The immunohistochemistry staining of the resected tissue is mandatory that allows establishing a correct diagnostic of GIST....
Source: Case Reports in Gastroenterology - September 24, 2021 Category: Gastroenterology Source Type: research
Leukocytoclastic Vasculitis as an Extraintestinal Manifestation of Crohn ’s Disease
Cutaneous involvement is one of the most common extraintestinal manifestations of inflammatory bowel disease (IBD). More commonly, pyoderma gangrenosum and erythema nodosum are noted, but psoriasis, aphthous stomatitis, Sweet ’s syndrome, and vasculitis may also occur. Leukocytoclastic vasculitis (LCV) is a rare cutaneous manifestation, characterized by the appearance of palpable purpura, urticaria, and ulcer-necrotic lesions predominantly in the lower extremities that improve with immunosuppressive therapy. In this ca se, we report a patient with CD and LCV. We also searched the literature on the diagnosis and treatment...
Source: Case Reports in Gastroenterology - September 23, 2021 Category: Gastroenterology Source Type: research
Long Survival after Gastrointestinal Bleeding in a New-Onset Heyde ’s Syndrome Patient Treated with Multiple Endoscopic Hemostatic Procedures and Repeated Transfusions after Aortic Valve Replacement
We report a 76-year-old Japanese female who underwent aortic mechanical valve replacement 1 year ago and presented with recurrent gastrointestinal bleeding in angiodysplasia of the sigmoid colon. Endoscopic interventions achieved hemostasis. Howe ver, 6 rebleeding events occurred due to a sigmoid colon ulcer and gastric and jejunal angiodysplasia 7 years after first hemostasis. The patient underwent multiple endoscopic hemostatic procedures (upper, lower, and balloon-assisted endoscopy) and repeated transfusions (total of 394 units of red bl ood cells). The intensive treatment contributed to the survival time of 10 years. ...
Source: Case Reports in Gastroenterology - September 23, 2021 Category: Gastroenterology Source Type: research
Diagnostic Challenge in a Patient Presenting with Ascites and Hypergammaglobulinemia
We described a 47-year-old female presenting with low serum-ascites albumin gradient (SAAG) and a markedly high level of serum globulin. Serum protein electrophoresis revealed an M spike in the gamma region. Other laboratory results showed a marked increase in aspartate aminotransferase and alanine aminotransferase and predominantly conjugated hyperbilirubinemia without a sign of dilatation of bile ducts from abdominal ultrasonography examination. Furthermore, the follow-up showed a positive result for the anti-nuclear antibody test. The patient was assessed with autoimmune hepatitis, and the cause of ascites was suggested...
Source: Case Reports in Gastroenterology - September 21, 2021 Category: Gastroenterology Source Type: research
