Abdominal Ascites of Unknown Origin: Diagnostic Accuracy of Adenosine Deaminase for Tuberculous Peritonitis
We present a case of persistently elevated adenosine deaminase in peritoneal ascites of a young, healthy female with new-onset ascites. An extended diagnostic evaluation was performed to reach the diagnosis.Case Rep Gastroenterol 2021;15:418 –423 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - April 6, 2021 Category: Gastroenterology Source Type: research
Clinical and Intestinal Histopathological Findings in SARS-CoV-2/COVID-19 Patients with Hematochezia
Gastrointestinal (GI) symptoms of SARS-CoV-2/COVID-19 in the form of anorexia, nausea, vomiting, abdominal pain and diarrhea are usually preceded by respiratory manifestations and are associated with a poor prognosis. Hematochezia is an uncommon clinical presentation of COVID-19, and we hypothesize that older patients with significant comorbidities (obesity and cardiovascular) and prolonged hospitalization are susceptible to ischemic injury to the bowel. We reviewed the clinical course, key laboratory data including acute-phase reactants, and drug/medication history in 2 elderly male patients admitted for COVID-19 respirat...
Source: Case Reports in Gastroenterology - March 22, 2021 Category: Gastroenterology Source Type: research
Collision Tumor of the Stomach
Collison tumor of the stomach is rare, and its endoscopic and pathological features remain poorly described. A 70-year-old woman was referred to our hospital for examination and treatment of undifferentiated gastric cancer. Esophagogastroduodenoscopy revealed a whitish, superficial elevated lesion in contact with a reddish, superficial depressed lesion from the anterior wall of the gastric angle and antrum to the lesser curvature. Laparoscopic distal gastrectomy was performed for preoperative diagnosis of suspected early gastric cancer presenting as a differentiated and undifferentiated collision tumor, which led to the le...
Source: Case Reports in Gastroenterology - March 18, 2021 Category: Gastroenterology Source Type: research
Non-Steroidal Anti-Inflammatory Drugs: A Rare Cause of Colonic Mass
NSAIDs (non-steroidal anti-inflammatory drugs) are one of the most used medications worldwide. Every day they are used by more than 30 million Americans. Here, we report a rare and interesting case of a 63-year-old woman with a history of NSAID use who presented to our emergency room with lower abdominal pain. Computed tomography (CT) scan of the abdomen with intravenous contrast revealed focal mucosal thickening in the cecum which was highly suspicious for colonic malignancy. She had a colonoscopy which showed two masses and ulcers in the right colon, pathology was negative for malignancy and showed inflammation consisten...
Source: Case Reports in Gastroenterology - March 18, 2021 Category: Gastroenterology Source Type: research
Successful Montelukast Treatment in an Infant with Steroid-Resistant Eosinophilic Colitis
We report an infant with steroid-resistant EC, who successfully returned to a healthy growth trajectory under the combined therapy of montelukast and ketotifen. An 8-month-old boy presented with bloody diarrhea, anemia, and failure to thrive (FTT) that started 6 days after birth. The patient has no known allergies. A trial of elementary diet was unsuccessful. The results of several stool cultures were unremarkable. Similarly, lower gastrointestinal series failed to identify anything significant. At 3 months of age, an esophagogastroduodenoscopy with biopsies from the distal duodenum and proximal jejunum were unremarkable. ...
Source: Case Reports in Gastroenterology - March 18, 2021 Category: Gastroenterology Source Type: research
Collision Tumor Comprising Primary Malignant Lymphoma and Adenocarcinoma in the Ascending Colon
We describe the case of a 78-year-old man with collision tumor from the primary malignant lymphoma and adenocarcinoma in the ascending colon. He suffered anemia from sigmoid colon cancer, and colonoscopy revealed early-stage colorectal cancer with a diameter of 20 mm in the cecum, the biopsy specimen showed moderately differentiated adenocarcinoma. Contrast-enhanced computed tomography (CT) revealed bowel wall thickening with contrast enhancement at the cecum; however, no lymph node and organ metastases were found. As above, we performed laparoscopic ileocecal resection with D3 lymph node dissection. The postoperative cour...
Source: Case Reports in Gastroenterology - March 18, 2021 Category: Gastroenterology Source Type: research
Concomitant Vancomycin-Resistant < b > < i > Enterococcus faecium < /i > < /b > and < b > < i > Clostridium difficile < /i > < /b > Colitis
We present a case of a 32-year-old American man who was initially admitted because of bilateral lower extremity weakness. The hospital course was complicated, with acute hypoxic respiratory failure secondary to pneumonia. The patient was intubated and was started on broad-spectrum antibiotics. Later on, the patient had severe diarrhea and was found to have clostridium difficile infection. Patient symptoms persisted despite completing the course of antibiotics. Colonoscopy was performed, and the patient was found to have a diffuse area of severely altered vascular, congested, erythematous, friable with contact bleeding, hem...
Source: Case Reports in Gastroenterology - March 15, 2021 Category: Gastroenterology Source Type: research
Don ’t Forget about the Sump! An Uncommon Complication Many Years after a Choledochoduodenostomy
We present the case of a 72-year-old male patient with multiple comorbidities. He presented to the ER because of recurrent episodes of cholangitis; after having obtained the patient’s medical records, lab and image studies, the latter showed pneumobilia. After considering all the results plus the pneumobilia we suspect the presence of this uncommon complication of CDS. The patient was subjected to an unsuccessful endoscopic treatment followed by surgery, after which he showed signs of improvement and adequate evolution till hospital discharge.Case Rep Gastroenterol 2021;15:365 –371 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - March 12, 2021 Category: Gastroenterology Source Type: research
Hematemesis, a Rare Presentation for Downhill Esophageal Varices
We describe such a case here involving a patient with DEV secondary to metastatic renal cell carcinoma presenting with hematemesis.Case Rep Gastroenterol 2021;15:359 –364 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - March 12, 2021 Category: Gastroenterology Source Type: research
Rare Etiology of Odynophagia in a Female Adolescent
Herpes esophagitis (HE) is a rare condition in immunocompetent adolescents. However, it commonly occurs as a primary infection in younger individuals. Herein, we report a 16-year-old female patient who had a history of fever for 5 days, odynophagia, and orolabial herpes infection for 7 days. Clusters of painful vesicles on an erythematous base on the lips, gingiva, and palate were observed on physical examination. Further, esophagogastroduodenoscopy revealed diffuse linear ulcerations in the distal esophagus. The patient then received the following treatment: intravenous (I.V.) acyclovir 5 mg/kg three times a day, I.V. ome...
Source: Case Reports in Gastroenterology - March 12, 2021 Category: Gastroenterology Source Type: research
Hepatic Epithelioid Hemangioendothelioma Presenting Synchronously with Hepatocellular Carcinoma
Hepatic epithelioid hemangioendothelioma (EHE) is a rare malignant tumor with unknown pathogenesis. Herein, we report a case of a hepatic EHE presenting synchronously with a hepatocellular carcinoma (HCC). To the best of our knowledge, this is the second case report of synchronous hepatic EHE and HCC. An 84-year-old man presented with back pain. During examination, a tumor in liver segment 3 was coincidentally detected. Tumor marker (carbohydrate antigen 19-9, alpha-fetoprotein, and protein induced by vitamin K absence or antagonist-II) levels were elevated. Contrast-enhanced computed tomography revealed perinodular enhanc...
Source: Case Reports in Gastroenterology - March 11, 2021 Category: Gastroenterology Source Type: research
Unusual Tissue – Unusual Issue: Pancreatic Heterotopia Presenting as Gastric Outlet Obstruction
We report a case of heterotop ic pancreas manifesting as severe gastric outlet obstruction, in addition to a thorough diagnostic workup and surgical follow-up, in a young adult. Differential diagnoses and features that speak to benignity of a large, symptomatic mass lesion (PH in particular) are discussed.Case Rep Gastroenterol 2021;15:338 –343 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - March 11, 2021 Category: Gastroenterology Source Type: research
Double Pylorus in Upper Gastrointestinal Bleeding
We present the case of a 59-year-old man who was admitted to Dr. Soetomo General Hospital with hematemesis and melena. The patient had a history of diabetes mellitus since 3 years and consumption of medicinal herbs for myalgia, which was suspected of NSAIDs for the past 5 months. The patient had anemia with hemoglobin at 8.3 g/dL, enterogenous azotemia with blood urea nitrogen 28 mg/dL and serum creatinine 1.14 mg/dL. At EGD, double pylorus was found and accompanied by gastric ulcer, a giant white base ulcer, part of it covered by clotting without any sign of active bleeding. Biopsy revealed chronic inactive gastritis, and...
Source: Case Reports in Gastroenterology - March 11, 2021 Category: Gastroenterology Source Type: research
A Gastric Intramucosal Mixed Adenocarcinoma-Neuroendocrine Tumor
Gastric mixed adenocarcinoma-neuroendocrine tumor (NET) is a rare composite tumor, and a limited number of studies have reported on it. A 77-year-old man was admitted to our hospital because of acute cholecystitis. He underwent a cholecystectomy. Esophagogastroduodenoscopy during his admission revealed a slightly elevated tumor, and biopsy demonstrated a well-differentiated tubular adenocarcinoma. The tumor was resected completely by endoscopic submucosal dissection. Histological findings showed that it measured 9 mm in diameter, was located within the mucosa, and consisted of well-differentiated tubular adenocarcinoma and...
Source: Case Reports in Gastroenterology - March 11, 2021 Category: Gastroenterology Source Type: research
Various Endoscopic Features in Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma
We reported the various endoscopic findings in the same MEITL patient by using single balloon endoscopy. We also summarized endoscopic characteristics of MEITL patients.Case Rep Gastroenterol 2021;15:312 –322 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - March 11, 2021 Category: Gastroenterology Source Type: research
