Hepatocellular Carcinoma with Distant Metastasis Cured by 20-Day Sorafenib Treatment
There are only 13 cases of complete remission after sorafenib use in advanced hepatocellular carcinoma (HCC) worldwide. We herein report a rarer case in which the patient was cured after only 20 days of sorafenib use. A 61-year-old male patient was diagnosed with a huge HCC. The mass occupied almost the whole of the right hepatic lobe and a portion of segment 4. We performed extended right hepatectomy for cure. However, 3.5-cm-sized subcarinal lymph node metastasis was detected at 15 months after operation. We prescribed sorafenib 400 mg bid for palliative treatment. The patient had severe fever, pain, and blisters on the ...
Source: Case Reports in Gastroenterology - July 8, 2021 Category: Gastroenterology Source Type: research
Advanced Colon Cancer after Curative Resection of Intramucosal Adenocarcinoma with Endoscopic Submucosal Dissection
Endoscopic resection, particularly endoscopic submucosal dissection (ESD), for colorectal cancers enables a precise pathological diagnosis and safe R0 resection. The recurrence rate after ESD is generally extremely low, with annual surveillance colonoscopy recommended. However, surveillance may not be considered for super-elderly patients owing to their condition. This is a case report of an 85-year-old man in whom curative resection was achieved for an intramucosal adenocarcinoma with ESD. The patient presented with a hypoechoic mass located in his lower right abdomen, diagnosed via surveillance abdominal ultrasound. He h...
Source: Case Reports in Gastroenterology - July 6, 2021 Category: Gastroenterology Source Type: research
Unhappy Triad: Infection with < b > < i > Leptospira < /i > < /b > spp. < b > < i > Escherichia coli < /i > < /b > and < b > < i > Bacteroides uniformis < /i > < /b > Associated with an Unusual Manifestation of Portal Vein Thrombosis
We report on a 76-year-old German male who was admitted with a history of recurrent fever and acute renal failure. Blood cultures taken on admission showedEscherichia coli, as well asBacteroides uniformis after an extended incubation period of 90 h. In addition, infection withLeptospira spp. was diagnosed serologically. Computerized tomography of the abdomen revealed an extensive PVT along with signs of colonic diverticulitis. Symptoms resolved under prolonged antimicrobial therapy with beta-lactams and adequate heparinization. A myeloproliferative disorder could be excluded. There was no evidence of an underlying coagulat...
Source: Case Reports in Gastroenterology - July 6, 2021 Category: Gastroenterology Source Type: research
Acute Esophageal Necrosis Secondary to a Paraesophageal Hernia
Acute esophageal necrosis (AEN) or “black esophagus” is a rare clinical entity caused by necrosis of distal esophageal mucosa stemming from esophageal ischemia. Possible etiologies are broad but most commonly include possible triggers of low-flow vascular states in the esophagus, including infections, broad-spectrum antibiotic us e, and gastric volvulus, among others. Patients most commonly present clinically with acute onset hematemesis and melena. Here, we describe a patient who initially presented with multiple nonspecific gastrointestinal symptoms, including abdominal pain and nausea, that progressed over a 10-day ...
Source: Case Reports in Gastroenterology - July 5, 2021 Category: Gastroenterology Source Type: research
Ansa Pancreatica, an Uncommon Cause of Acute, Recurrent Pancreatitis
The pancreatic duct is vulnerable to developmental anomalies which may produce variations in its course and/or its configuration. Ansa pancreatica is the least common anatomic variant. It is characterized by the formation of an “S-shaped loop” from the main pancreatic duct to the minor papilla. Ansa pancreatica has been implicated as a cause of recurrent acute pancreatitis. We review existing literature on pancreatitis secondary to the ansa deformity and present a case of recurrent acute pancreatitis in a patient who w as ultimately found to have the ansa deformity on endoscopic ultrasound.Case Rep Gastroenterol 2021;1...
Source: Case Reports in Gastroenterology - July 1, 2021 Category: Gastroenterology Source Type: research
Biliary Schwannoma That Required Differentiation from Bile Duct Cancer
We report the case of a 78-year-old man who presented with no abdominal symptoms or jaundice. CT imaging showed a hyperdense mass extending along the extrahepatic bile duct, and the upstream bile ducts were dilated. We performed extrahepatic bile duct resection under a preoperative diagnosis of the extrahepatic bile duct cancer. A histopathological examination of the resected specimen revealed that the tumor consisted of spindle cells which exhibited a palisading arrangement. Immunohistochemical staining was positive for protein S-100 and vimentin. Based on these pathological findings, we diagnosed the patient with schwann...
Source: Case Reports in Gastroenterology - June 30, 2021 Category: Gastroenterology Source Type: research
Diagnosis of Fibrotic Distal Ileum Stenosis after Ischemic Enteritis Using Transabdominal Ultrasonography
Ischemic enteritis (IE) is a rare disorder which is caused by inadequate blood flow to small intestine. The diagnostic procedure of this disease has not sufficiently established because of its rarity. Here, we report a case of IE in a hemodialysis-dependent 70-year-old man and summarize the diagnostic options for IE. The patient was admitted to our hospital because of acute abdominal distention and vomiting. He presented with mild tenderness in the lower abdomen and slightly elevated C-reactive protein level as revealed by blood tests. Radiographic imaging showed small bowel obstruction due to a stricture in the distal ile...
Source: Case Reports in Gastroenterology - June 23, 2021 Category: Gastroenterology Source Type: research
Successful Conversion Surgery for Stage IV Gastric Cancer after Nivolumab Monotherapy as Third-Line Chemotherapy
There are few reports of conversion surgery (CS) after nivolumab monotherapy because it is considered as a third-line standard chemotherapy for unresectable or recurrent gastric cancer. Here, we report a rare case of stage IV gastric cancer effectively treated with CS after nivolumab monotherapy as a third-line chemotherapy. A 73-year-old man was referred to our hospital with loss of appetite and abdominal discomfort. Stage IV gastric cancer with liver metastasis was diagnosed via upper gastrointestinal endoscopy and CT. Twelve courses of capecitabine, cisplatin, and trastuzumab were administered as the first-line treatmen...
Source: Case Reports in Gastroenterology - June 23, 2021 Category: Gastroenterology Source Type: research
Plummer-Vinson Syndrome in an African-American Woman
We present a rare case of PVS in an African-American woman. A 63-year-old woman presented with shortness of breath, dysphagia, and lightheadedness for several weeks. Chest X-ray was negative for any acute abnormalities. Initial hemoglobin was 7.0 g/dL, which improved to 7.5 g/dL after 1 unit of packed red blood cells. She had a mean corpuscular volume of 62 fL, a ferritin level of 6 ng/mL, and an iron level of 12 μg/dL. Fecal occult blood test was negative and barium swallow revealed a proximal esophageal web. Her dysphagia did not significantly improve despite intravenous iron supplementation and esophageal web dilation....
Source: Case Reports in Gastroenterology - June 22, 2021 Category: Gastroenterology Source Type: research
Recurrent Dysphagia Associated with Esophageal Intramural Pseudodiverticulosis
We present a rare case of EIPD complicated with esophageal strictures. The case is unique because the small lesions of EIPD remained undiagnosed for many years on prior esophagogastroduodenoscopy examinations until complicated with worsening symptoms of dysphagia due to esophageal stricture. The patient was managed with serial dilations of esophageal stricture. Diagnosing these lesions may be missed in early stages as the lesions are small and may require other radiological modalities to confirm the diagnosis. EIPD lesions itself can be managed conservatively with anti-inflammatory therapy and treatment of underlying risk ...
Source: Case Reports in Gastroenterology - June 21, 2021 Category: Gastroenterology Source Type: research
Delayed Presentation of Congenital Jejunal Web beyond the Neonatal Period
In this report, we document a case of 14-month boy with retention of accidently ingested button battery who was found to have a jejunal web on surgical exploration. This case report stresses on the importance of prevention of ingestion of inanimate foreign bodies especially in young infants and that the absence of symptoms does not preclude presence of foreign body in children. Also, surgeons should be prepared to deal with other unsuspected findings intraoperatively. After a review of the literature, jejunal web should be considered in the differential diagnosis of chronic partial intestinal obstruction even in adults.Cas...
Source: Case Reports in Gastroenterology - June 21, 2021 Category: Gastroenterology Source Type: research
Proton Pump Inhibitor-Associated Large Hyperplastic Polyp in Non- < b > < i > Helicobacter pylori < /i > < /b > -Infected Stomach
A proton pump inhibitor (PPI)-associated hyperplastic polyp (HP) in the non-Helicobacter pylori-infected stomach is rare, and its endoscopic features remain poorly described. A 42-year-old man with tarry stool was referred to our hospital for examination and treatment. He had taken PPI for 14 years and was confirmed to beH. pylori-negative. Transnasal endoscopy revealed bleeding from a 20-mm, reddish pedunculated polyp with a nodular surface, located in the greater curvature of the upper gastric body. Endoscopic mucosal resection was performed, and the lesion was diagnosed as an HP. To our knowledge, this report represents...
Source: Case Reports in Gastroenterology - June 21, 2021 Category: Gastroenterology Source Type: research
Atypical Presentation of Esophageal Squamous Cell Carcinoma Masquerading as Diffuse Severe Esophagitis
We present a case of a 61-year-old man who presented to the gastroenterology clinic for dysphagia and heartburn of 3 months duration. The patient had lost about 15 pounds unintentionally over 6 months. The patient underwent esophagogastroduodenoscopy, which revealed significant diffuse Grade 4 esophagitis without any overt bleeding. Random biopsies were taken with cold forceps from proximal, middle, and distal esophageal segments because of the striking endoscopic appearance. Histopathology revealed high-grade dysplasia and carcinoma in situ. The patient underwent endoscopic ultrasound (EUS) of the esophagus, which reveale...
Source: Case Reports in Gastroenterology - June 17, 2021 Category: Gastroenterology Source Type: research
Epiploic Appendagitis: A Riddle for Right Lower Quadrant Pain!
Epiploic appendagitis (EA) is inflammation of epiploic appendages, which are pedunculated fatty structures, extend from the cecum to the rectosigmoid junction, and are covered by the peritoneum. Torsion, infarction, and inflammation of it present with acute lower abdominal pain and localized tenderness in a well-looking patient. It poses as diagnostic conundrum due to its rarity and not picked by conventional radiography. A 50-year-old male presented with pain in RLQ for past 1 day, which kept on increasing without any other symptoms. His abdomen was soft with tenderness localized to the right lower quadrant (RLQ), classic...
Source: Case Reports in Gastroenterology - June 17, 2021 Category: Gastroenterology Source Type: research
Duodenal Gastrointestinal Stromal Tumor: A Rare Disease in a Young Adult Female Patient Presenting with Life-Threatening Hemorrhage
In this study, we report a case of potentially lethal bleeding dGIST in a young woman successfully treated by an organ-preserving elective surgery after endoscopic and angiographic hemostasis. A 26-year-old female patient was admitted to the Emergency Unit of our hospital with the complaints of hematemesis and melena in the previous 12 h. An upper endoscopy showed a 4-cm submucosal lesion, between the 2nd and 3rd part of the duodenum, in the lateral wall, with massive bleeding arising from central ulceration. Hemostasis was initially achieved endoscopically and then optimized by transarterial embolization. After a contrast...
Source: Case Reports in Gastroenterology - June 14, 2021 Category: Gastroenterology Source Type: research
