Large Metastatic Cardiac Tumor from Ascending Colon Cancer with Autopsy
We report a case of synchronous double cancer of the prostate and ascending colon with metastases to multiple organs, including a large cardiac tumor. A 71-year-old Japanese man had prostate cancer with neck and para-aortic metastasis. He visited our hospital with complaints of fatigue and a positive fecal occult blood test result. Colonoscopy findings revealed the presence of a tumor in the ascending colon, and contrast-enhanced CT revealed a tumor in the heart, which was possibly due to metastasis from the ascending colon. The patient received palliative care and declined anticancer treatment. He died due to respiratory ...
Source: Case Reports in Gastroenterology - August 2, 2021 Category: Gastroenterology Source Type: research
Myeloid Sarcoma Presenting as Obstructive Jaundice
We present the case of a previously healthy 36-year-old male, who was admitted to hospital with new-onset painful obstructive jaundice and final diagnosis of isolated MS was made after through investigations. We are pleased to report that he had favorable response to the treatment and remains well.Case Rep Gastroenterol 2021;15:695 –702 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - August 2, 2021 Category: Gastroenterology Source Type: research
Pseudomelanosis Duodeni Appearing after Oral Iron Therapy
We present a case of pseudomelanosis duodeni appearing after 2 years of oral iron therapy in an 85-year-old woman. Although oral iron supplementation seemed the strongest possible etiology, our patient had multiple comorbidities and was on other medications that have been described as associations. The majority of individuals taking oral iron or under these clinical conditions do not develop this entity; some other factors in patients may be responsible for its occurrence.Case Rep Gastroenterol 2021;15:689 –694 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - July 29, 2021 Category: Gastroenterology Source Type: research
A 3D Quantitative MRC Modeling Images Detected Case of Intrahepatic Biliary Stricture Diseases
In the future, the application of quantitative imaging and computational analysis will reduce the burden on radiologists. We herein report 8 pilot cases both with and without intrahepatic biliary stricture (IHBS) diseases which have been analyzed with the novel analytical system MRCP+ (Perspectum Ltd., Oxford, UK). The colored and well-visualized 3D models of the entire biliary trees could be obtained in all 8 cases. Three representative cases did not show dilated regions in the intrahepatic bile ducts. Cases diagnosed as a pancreatico-biliary maljunction showed slightly increased dilated visualization in the extrahepatic ...
Source: Case Reports in Gastroenterology - July 26, 2021 Category: Gastroenterology Source Type: research
Laparotomy-Assisted Direct Cholangioscopy for Bile Duct Stone Removal via an Incision of the Jejunum
A 77-year-old man presented to our hospital with epigastric pain. He had previously undergone hepatic left lateral segmentectomy, cholangiojejunostomy, and Roux-en-Y reconstruction at 42 years of age for intrahepatic stones and liver abscesses. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed bile duct stones and intrahepatic bile duct dilation of the caudate lobe. Bile duct drainage for the caudate lobe was necessary; however, the volume of his caudate lobe was very small, making percutaneous transhepatic biliary drainage (PTBD) or endoscopic ultrasound-guided biliary drainage (EUS-BD...
Source: Case Reports in Gastroenterology - July 22, 2021 Category: Gastroenterology Source Type: research
Unusual Presentation of a Gastrointestinal Stromal Tumor in a Small Intestine Diverticulum
A 50-year-old female with no significant medical history initially presented to an urgent care center with symptoms of acute onset abdominal pain, nausea, and emesis. Chest and abdominal X-ray revealed free air under the diaphragm, prompting immediate transfer to the emergency department. Continued abdominal tenderness and pain were concerning for perforated viscus. The patient was transferred to the operating room, and diagnostic laparoscopy was performed. Inflammation and contamination were discovered in the right side of the abdomen and pelvis secondary to a small bowel (SB) perforation. Segmental SB resection revealed ...
Source: Case Reports in Gastroenterology - July 21, 2021 Category: Gastroenterology Source Type: research
Pustular Rash in Crohn ’s Patient on Ustekinumab Raises Concern for Drug-Induced Paradoxical Psoriasis
We report the case of a 51-year-old male with Crohn ’s disease (CD) who developed a reproducible pustular rash after ustekinumab (UST) administration. The patient first presented with a pustular rash on his hands, body, extremities, and scalp starting 5 weeks after his initial weight-based UST induction. The rash resolved spontaneously, then recurr ed 4 weeks after his first subcutaneous maintenance dose of UST 90 mg. Biopsy of the affected area demonstrated subcorneal pustular dermatosis (SPD). UST was discontinued and the rash resolved. Unfortunately, the patient experienced clinical recurrence of CD, and given prior f...
Source: Case Reports in Gastroenterology - July 20, 2021 Category: Gastroenterology Source Type: research
Successful Drug Desensitization to Ustekinumab in a Patient with Crohn ’s Disease
We present a pediatric patient with Crohn ’s disease who did not tolerate infliximab and was then changed to ustekinumab. He developed anaphylaxis to the medication after the second dose. A drug desensitization protocol was created by the allergy team leading to successful administration of both intravenous and then subcutaneous ustekinum ab. As monoclonal agents become mainstays of therapy for inflammatory conditions, there are increased reports of allergic reactions. Prior reports and protocols of ustekinumab desensitization have not been reported. This case report highlights successful desensitization to ustekinumab a...
Source: Case Reports in Gastroenterology - July 20, 2021 Category: Gastroenterology Source Type: research
Asymptomatic Eosinophilic Infiltration with Endoscopic and Histological Findings Consistent with Eosinophilic Gastritis
Eosinophilic gastritis often presents with gastrointestinal symptoms in the absence of abnormal endoscopic findings. On the other hand, endoscopic changes due to eosinophilic infiltration in an asymptomatic patient are rare. A 29-year-old woman with a history of asthma on steroid inhalers presented for an annual medical checkup. Esophagogastroduodenoscopy revealed diffuse white granular patches in the body of the stomach, suggestive of eosinophilic gastritis. Histology showed over 100 eosinophils per high-power field, also consistent with eosinophilic gastritis. As the absence of symptoms precluded the diagnosis of eosinop...
Source: Case Reports in Gastroenterology - July 19, 2021 Category: Gastroenterology Source Type: research
Intrahepatic Bile Duct Injury as a Hepatic Immune-Related Adverse Event after Immune-Checkpoint Inhibitor Treatment
This study describes 2 patients with hepatic irAEs manifesting as intrahepatic bile duct injury. Immunostaining with antibodies to both CD8 and cytokeratin-7 was useful for the diagnosis, and both patients were refractory to steroid treatment. Prompt diagnosis and active immunosuppressive therapies are required in such cases.Case Rep Gastroenterol 2021;15:645 –651 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - July 13, 2021 Category: Gastroenterology Source Type: research
Recurrence of Adult Granulosa Cell Tumor in the Greater Omentum 11 Years after Surgery
We report a case of AGCT recurrence in the greater omentum that was resected during laparoscopic cholecystectomy. A patient visited our hospital with right-sided abdominal pain. The CT revealed gallbladder stones, a ureteral stone, and a right abdominal mass. The diagnosis of the abdominal tumor was difficult on the basis of blood biochemical testing, gastrointestinal endoscopy, or image inspection. Although the patient underwen t several previous surgeries and there were no findings of malignancy with positron emission tomography, we chose to resect the tumor for combined diagnosis and treatment during laparoscopic cholec...
Source: Case Reports in Gastroenterology - July 9, 2021 Category: Gastroenterology Source Type: research
Perigastric Hyaline-Vascular Variant Castleman ’s Disease
This report presents a case of a 50-year-old female diagnosed with hyaline-vascular variant CD in a random physical examination, the ultrasound examination first revealed a 24.3 mm × 15.4 mm hypoechogenic lesion abutting the stomach, esophagus, and liver, which was under the suspicion of gastrointestinal stromal tumor. Following a series of medical examinations, including CEUS, CT, postoperative histopathological examination, and immunohistochemical analysis, the patient was diagnosed with hyaline-vascular variant unicentric CD. After the mass was completely excised through laparoscopic surgery, the woman recovered very w...
Source: Case Reports in Gastroenterology - July 9, 2021 Category: Gastroenterology Source Type: research
Multidrug Resistance and Flaring up of Manifestation in Fistulizing Crohn ’s Disease after Surgery on a Perianal Lesion
In conclusion, clinicians should be aware that abscess and fistula have a fair chance to develop in Crohn ’s disease patients who are using immunomodulating and immunosuppressant therapy. In abscess and fistula cases, surgery should be determined as soon as possible, and close clinical monitoring should be performed. We recommend routine screening for enteric fistula and culture sensitivity of any dis charge prior to the initiation of any antibiotic. Appropriate intervention should then be undertaken.Case Rep Gastroenterol 2021;15:626 –631 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - July 8, 2021 Category: Gastroenterology Source Type: research
Colitis Induced by Colon-Cleansing Agent
We report a case of a 35-year-old African American man with a past medical history of IBS who presented to the clinic with a chief complaint of abdominal pain and bloody diarrhea for 1 week. The patient stated that he used a colon-cleansing agent because of persistent constipation. Computed tomography scan of the patient ’s abdomen and pelvis with contrast was performed which showed diffuse contiguous segmental mural thickening and nodularity seen along the distal transverse, descending, and sigmoid colon. Colonoscopy showed moderate diffuse inflammation characterized by altered vascularity, erythema, and granular ity fr...
Source: Case Reports in Gastroenterology - July 8, 2021 Category: Gastroenterology Source Type: research
Herpes Simplex Virus Esophagitis in the Setting of Acute Use of Corticosteroids for COPD Exacerbation in an Immunocompetent Middle-Aged Woman
We present a case of acute gastrointestinal bleeding secondary to HSV type 1-induced esophageal ulcers. A 63-year-old woman developed acute hypoxic hypercapnic respiratory failure. Past medical history was significant for COPD for which the patient was taking short-acting bronchodilator inhalers. The patient was intubated and started on mechanical ventilation. Intravenous Solu-Medrol 40 mg Q6 was started. Hospital course was complicated by sepsis of unknown source. Empiric broad-spectrum antibiotic therapy was started. On the 11th hospital day, the patient experienced multiple episodes of coffee ground emesis. There was ab...
Source: Case Reports in Gastroenterology - July 8, 2021 Category: Gastroenterology Source Type: research
