Perforated Acute Appendicitis in a Six-Day-Old Neonate: A Rare Differential Diagnosis of Neonatal Peritonitis
Acute appendicitis is a rare diagnosis of acute abdomen in neonates which is associated with high mortality due to late diagnosis. Here, we presented a case of acute neonatal appendicitis in a 6-year-old full-term infant with Down syndrome and pulmonary atresia with ventricular septal defect. The patient underwent surgery and postoperative critical care. However, he died on postoperative day 5 due to worsening sepsis and decompensated hemodynamic instability.Case Rep Gastroenterol 2021;15:188 –194 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - February 16, 2021 Category: Gastroenterology Source Type: research
Hepatitis B Virus Reactivation with Discontinuation of Nucleoside Analogue in Patients Who Received Allogeneic Hematopoietic Stem Cell Transplantation
Reactivation of hepatitis B virus (HBV) is known to occur frequently after hematopoietic stem cell transplantation (HSCT). The reactivation can be prevented by nucleos(t)ide analogue (NA), but it is unclear how long NA should be continued. Here, we report 3 cases of HBV reactivation with discontinuation of NA following the discontinuation of immunosuppressive therapies after HSCT. Three male patients aged 34, 59, and 54 years received allogeneic HSCT (allo-HSCT) for chronic myeloid leukemia, mixed phenotype acute leukemia, and myelodysplastic syndrome, respectively. Before HSCT, 2 patients were positive for hepatitis B sur...
Source: Case Reports in Gastroenterology - February 12, 2021 Category: Gastroenterology Source Type: research
Acute Gastric Dilatation: A Cause for Concern
We present our experience of 2 patients who presented with severe hyperglycemia and were found to have acute gastric dilation on imaging. Only one of the patients was treated with nasogastric tube placement for decompression and eventually made a full recovery.Case Rep Gastroenterol 2021;15:171 –177 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - February 12, 2021 Category: Gastroenterology Source Type: research
IgG4-Related Pseudotumors Mimicking Metastases in Liver and Lungs
A 47-year-old man complained intermittent dull pain at the right upper quadrant abdomen and right neck swelling for 3 months. Blood tests revealed leukocytosis with mild eosinophilia. Computed tomography (CT) showed the presence of multiple nodules in the liver and both lung fields. Positron emission tomography/CT (PET/CT) scans found increased uptake at lymph nodes of the right neck, in the lung, liver, and prostate. The patient was diagnosed with IgG4-related disease (IgG4-RD) based on the biopsy findings from the right neck lymph nodes, showing enriched IgG4-positive lymphoplasmacytic cells. It is often difficult to dis...
Source: Case Reports in Gastroenterology - February 12, 2021 Category: Gastroenterology Source Type: research
Cholangiocarcinoma Presenting after Eight Years of Treatment of IgG4-Related Autoimmune Pancreatitis with Steroids
We report a patient with IgG4-related AIP who developed cholangiocarcinoma after 8 years of steroid treatment. A 76-year-old male presented with fever (37.8 °C) due to biliary obstruction and cholangitis. He had been treated with steroids for 8 years to control inflammation due to IgG4-related AIP. During 8 years of treatment, hepatobiliary enzyme levels were well controlled within their normal range, but serum IgG4 levels remained elevated. A computed tomography scan showed intrahepatic bile duct dilatation. Magnetic resonance cholangiopancreatography showed obstructive changes at the junction of the cystic and common du...
Source: Case Reports in Gastroenterology - February 5, 2021 Category: Gastroenterology Source Type: research
Dramatic Deep and Durable Remission of Acute Fulminant Ulcerative Colitis Achieved with Cyclosporine in a Patient Who Failed the Induction Intravenous Phase of Cyclosporine
We present the case of a 36-year-old man with acute severe UC refractory to steroids and multiple biologics, who “failed” IV cyclos porine for 2 weeks, much longer than the usually accepted induction phase, and achieved remission with continuation of oral cyclosporine. This case demonstrates the possibility that continued therapy with cyclosporine for a longer duration than the currently accepted timeline can lead to remission a nd avoidance of colectomy in properly selected and monitored patients.Case Rep Gastroenterol 2021;15:147 –153 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - February 4, 2021 Category: Gastroenterology Source Type: research
Wilson ’s Disease Presenting in Late Adult Life
We report a case of WD presenting with liver function impairment in late adult life and started on treatment. Therefore, early diagnosis and treatment of WD can prevent related complications.Case Rep Gastroenterol 2021;15:142 –146 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - February 4, 2021 Category: Gastroenterology Source Type: research
Endoscopic Removal of a Press-Through Pack from the Anal Canal
The incidence of press-through pack (PTP) ingestion has been increasing. In many cases, the ingested PTP is lodged in the esophagus. Here, we report a case of endoscopic removal of a PTP from the anal canal. An 89-year-old man with mild dementia presented with a 3-day history of anal pain. On digital rectal examination, we felt a hard and sharp object, which could not be manually removed due to its shape. Therefore, it was removed endoscopically. We inserted an endoscope with a large-caliber soft oblique cap and observed the PTP in the anal canal. It was successfully removed using grasping forceps. The patient was stable, ...
Source: Case Reports in Gastroenterology - February 3, 2021 Category: Gastroenterology Source Type: research
Pancreatic Metastasis from Malignant Melanoma: Not All That Glitters Is Gold
We present a case of metastatic melanoma to the pancreas. A 60-year-old man presented with a history of weight loss, vague abdominal pain, jaundice, and pruritus. Laboratory tests showed increased total bilirubin, with a direct fraction predominance, as well as increased alkaline phosphatase and gamma glutamyl transferase. Imaging studies revealed a mass in the head of the pancreas. Endoscopic ultrasound (EUS)-guided fine needle biopsy was performed, and histologic examination confirmed the diagnosis of metastatic melanoma. This case report illustrates the invaluable use of EUS-guided tissue acquisition in the study of pan...
Source: Case Reports in Gastroenterology - February 3, 2021 Category: Gastroenterology Source Type: research
Large Fundic Gland Polyp Associated with Long-Term Proton Pump Inhibitor Administration Mimicking Gastric-Type Neoplasm
A 57-year-old man with a 10-year history of proton pump inhibitor (PPI) use presented with multiple fundic gland polyps (FGPs) including one #x3e;20 mm, whitish, semi-pedunculated polyp. Black spots and cobblestone-like mucosa were also observed in the stomach upon endoscopy; therefore, the lesion was considered to result from long-term PPI administration. Endoscopically, we diagnosed this polyp as a neoplastic lesion with gastric phenotype rather than a non-neoplastic lesion. Biopsy revealed an atypical glandular lesion that was indeterminate for neoplasia; therefore, we performed en bloc resection via endoscopic submucos...
Source: Case Reports in Gastroenterology - February 3, 2021 Category: Gastroenterology Source Type: research
Hepatitis E Viral Association with Autoimmune Hepatitis: A Viral Trigger or Cross-Reactivity
We present a case of a 36-year-old lady with systemic lupus erythematosus who presented with abdominal pain, nausea, vomiting, and jaundice. She was initially diagnosed as acute hepatitis E virus (HEV) infection based on positive serology, but she did not improve with conservative management. Subsequently, she underwent liver biopsy that showed features characteristic of AIH. We discuss the role of HEV as a possible trigger of AIH. We also highlight the possibility of cross-reactivity between liver antigens and HEV as an explanation for the positive HEV serology in AIH. We explore the management options of cases in which b...
Source: Case Reports in Gastroenterology - February 3, 2021 Category: Gastroenterology Source Type: research
Cystic Pancreatic Neuroendocrine Tumor in a Patient with Neurofibromatosis Type 1
Neurofibromatosis type 1 (NF-1) is strongly associated with neurofibromas and malignancies. Solid pancreatic neuroendocrine tumors (PanNETs) have been recently reported in patients with NF-1. PanNETs are always solid and rarely present with a cystic appearance due to central necrosis and hemorrhage caused by rapid growth. A 33-year-old female diagnosed with NF-1 at age 16 was referred for evaluation of a pelvic mass found on abdominal ultrasound. Magnetic resonance imaging showed a 6 cm solid pelvic mass adjacent to the left external iliac artery, and contrast-enhanced computed tomography scan showed a 3-cm solid para-aort...
Source: Case Reports in Gastroenterology - February 1, 2021 Category: Gastroenterology Source Type: research
Diffuse Gallbladder Adenomyomatosis with an Inflammatory Complication in an Adult
We present the rare case of a 51-year-old man who was admitted to hospital due to abdominal pain concomitant with inflammatory syndrome. Imaging and histological findings were appropriate to diagnose diffuse GA and complication of cholecystitis.Case Rep Gastroenterol 2021;15:100 –107 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - February 1, 2021 Category: Gastroenterology Source Type: research
Response to “Cytomegalovirus Enterocolitis in a Patient with Refractory Immune-Related Colitis”
Case Rep Gastroenterol 2021;15:97 –99 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - January 26, 2021 Category: Gastroenterology Source Type: research
Recurrent Encephalopathy and Severe Anion Gap Metabolic Acidosis in a Patient with Short Bowel: It Is D-Lactic Acidosis
We present the case of a 61-year-old female with a history of an ileojejunal bypass at age 18 who presented to hospital with acute-onset encephalopathy, ataxia, and severe anion gap metabolic acidosis (AGMA). On initial investigations there were no identifiable etiologies for the AGMA. Further history revealed that she had been experiencing these symptoms on a recurrent basis for the past 40 years. An oral carbohydrate load was given to the patient in hospital which reproduced her symptoms and the AGMA. A serum D-lactate level returned elevated several weeks later. A 2-month follow-up revealed that all her symptoms had cea...
Source: Case Reports in Gastroenterology - January 26, 2021 Category: Gastroenterology Source Type: research
