Colonic Dilatation Complicating Acute Severe Ulcerative Colitis Managed Successfully with Accelerated Infliximab Dosing
We report a rare case of known psoriasis treated by secukinumab in a patient who presented with ASUC and colonic dilatation. Neither steroids nor standard infliximab regimen was effective. Finally, rescue therapy with accelerated infliximab strategy resulted in excellent recovery. In certain cases of steroid-refractory ASUC complicated by megacolon, accelerated infliximab regimen can be an alternative to surgery.Case Rep Gastroenterol 2022;17:82 –88 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - February 7, 2023 Category: Gastroenterology Source Type: research
Traditional Serrated Adenoma of the Ileum with Intussusception Successfully Treated with Laparoscopic Bowel Resection
The most common site of traditional serrated adenomas (TSA) is the area from the left colon to the rectum; however, there are few reports on TSA in the small intestine. Herein, we report a case of TSA of the ileum with intussusception that was diagnosed and successfully treated with laparoscopic bowel resection. The patient was a 29-year-old female with the chief complaint of recurrent abdominal pain and vomiting. Contrast-enhanced computed tomography showed a mass in the ileum and intussusception with the mass as the lead point. The patient was diagnosed with intussusception secondary to a small intestinal tumor. Due to t...
Source: Case Reports in Gastroenterology - February 7, 2023 Category: Gastroenterology Source Type: research
Normal Splanchnic Blood Flow in a Patient with Severe Stenosis of the Celiac Artery and Superior Mesenteric Artery
The diagnosis of chronic mesenteric ischaemia is typically based on angiographic findings along with a classic symptomatology. Only a few methods are available for functional testing to establish the diagnosis, such as indirect measurement of the splanchnic blood flow and hepatic vein oxygenation. The present case is a 76-year-old woman with weight loss and intermittent abdominal pain who was clinically suspected of chronic mesenteric ischaemia based on severe stenosis of the celiac artery and superior mesenteric artery. Measurement of the total splanchnic blood flow and hepatic vein oxygenation, however, showed a normal p...
Source: Case Reports in Gastroenterology - February 3, 2023 Category: Gastroenterology Source Type: research
A Patient with Transverse Colon Cancer Complicated by Cowden Syndrome Administered FOLFOXIRI + Bevacizumab Therapy
Cowden syndrome is characterized by several clinical features related to tumorous lesions primarily consisting of systemic hamartomas. The mutation of a tumor suppressor gene, thePTEN gene, is etiologically involved. As gastrointestinal lesions, polyps of all digestive tracts involving the esophagus to rectum develop. In patients with Cowden syndrome, the risk of colorectal cancer may increase. However, the characteristics of colorectal cancer in these patients remain to be clarified and sufficient findings regarding chemotherapy have not been obtained. A 39-year-old man was treated with a colonic stent for colitis obstruc...
Source: Case Reports in Gastroenterology - January 27, 2023 Category: Gastroenterology Source Type: research
Progression of Recurrent Pancreatitis to Chronic Pancreatitis within 3 Years due to < i > SPINK1 < /i > Mutation IVS3+2T & gt;C
When the etiology of pancreatitis cannot be determined despite sufficient investigation, recurrence and progression to chronic pancreatitis often involve genetic mutations. Herein, we describe a case of recurrent pancreatitis with the IVS3+2Tgt;C mutation in the serine protease inhibitor Kazal type 1 (SPINK1) gene that progressed to chronic pancreatitis in only 3 years. A 35-year-old man was referred to our hospital, where he was diagnosed with mild pancreatitis and was treated conservatively. However, the patient experienced recurrent episodes of pancreatitis, which progressed to become chronic pancreatitis with a pancrea...
Source: Case Reports in Gastroenterology - January 27, 2023 Category: Gastroenterology Source Type: research
< i > Helicobacter pylori < /i > Reinfection Diagnosed by Endoscopic and Histologic Recurrence in a Patient with Gastric Mucosa-Associated Lymphoid Tissue Lymphoma
Helicobacter pylori infection is a major cause of gastric mucosa-associated lymphoid tissue (MALT) lymphoma. SuccessfulH. pylori eradication can induce a complete remission (CR); however, it takes a long time. In this case, the recurrence of gastric MALT lymphoma was observed by endoscopic and histologic findings during a 11-year follow-up and due toH. pylori reinfection twice. After the first successful eradication and achieving histologic CR, the patient was starting to work at a nursing home for older adults, where she frequently came in contact with their vomitus or feces. In the examinations 2 years later after the fi...
Source: Case Reports in Gastroenterology - January 10, 2023 Category: Gastroenterology Source Type: research
Hypereosinophilic Syndrome Secondary to Ulcerative Colitis and Primary Sclerosing Cholangitis
In this report, we describe a case of a UC and primary sclerosing cholangitis patient who was diagnosed with HES and severe cardiovascular and neurological injury. During hospitalization, an extensive diagnostic workup was performed and secondary causes of hypereosinophilia were ruled out. The patient was treated with glucocorticoids and full anticoagulation with significant clinical improvement and a marked reduction in the eosinophil count. In the literature, hypereosinophilia in the IBD population has been related to the severity of the disease and worse prognosis. The high index of clinical suspicion and the accurate d...
Source: Case Reports in Gastroenterology - January 10, 2023 Category: Gastroenterology Source Type: research
Regression of Autoimmune Gastritis after Eradication of < i > Helicobacter pylori < /i >
We report a case of autoimmune gastritis (AIG) in which gastric mucosal atrophy improved withHelicobacter pylori eradication. Based on endoscopic findings (advanced gastric atrophy with vascular visibility and diffuse redness in remnant oxyntic mucosa), a woman in her 40s was suspected of having AIG coexisting with an activeH. pylori infection. This was confirmed by a positive anti-parietal cell antibody (PCA, 1:160), an elevated serum gastrin level (638 pg/mL), and positive anti-H. pylori antibody (Hp Ab, 15.5 U/mL) andH. pylori stool antigen tests. Seven months after eradication, reduced vascular visibility and disappear...
Source: Case Reports in Gastroenterology - January 10, 2023 Category: Gastroenterology Source Type: research
Onset of Oral Lichen Planus Led to Direct-Acting Antiviral Therapy in a Patient with Long-Term Hepatitis C: The Role of a Dentist as Gatekeeper
Oral lichen planus (OLP), a chronic inflammatory mucocutaneous disease, is an extrahepatic manifestation of a hepatitis C virus infection. In recent years, direct-acting antivirals (DAAs) have made great strides in the treatment of hepatitis C. However, there might be a lack of information about the treatment strategies available among those with this condition. Herein, we report a case of an 85-year-old female patient who was diagnosed with hepatitis C at the age of 55 but had not received antiviral treatment over the past 30 years. She underwent DAA treatment following a recommendation from her oral surgeon after the ons...
Source: Case Reports in Gastroenterology - January 9, 2023 Category: Gastroenterology Source Type: research
Intraductal Papillary Mucinous Neoplasm of the Pancreas Associated with Polycystic Liver and Kidney Disease
A 77-year-old man was pointed out thrombocytopenia and polycystic liver and kidney disease following hypertension and diabetes mellitus and duodenitis. He consulted to our hospital for further examination. Computed tomography (CT) showed multiple cysts in the liver and kidney and also showed cystic lesions in the pancreatic tail. The size of the tumor of pancreas was 3 cm × 4 cm. FDG-PET CT showed FDG uptake in the tumor of the pancreatic tail. It has not showed metastasis in the other organs. The examinations suggested that the cause of thrombocytopenia was infection ofHelicobacter pylori or idiopathic thrombocytopenic p...
Source: Case Reports in Gastroenterology - January 9, 2023 Category: Gastroenterology Source Type: research
Distinction between Mitochondrial Antibody-Positive and -Negative Primary Biliary Cholangitis
Antimitochondrial antibody-positive primary biliary cholangitis (AMA-pos PBC) is an autoimmune disorder in which monoclonal antibodies are produced against epitopes in the mitochondrial membranes of biliary epithelial cells, resulting in progressive nonsuppurative biliary cholangitis. Up to 5% of patients lack these autoantibodies, termed antimitochondrial antibody-negative (AMA-neg) PBC. Although a somewhat new variant of AMA-pos PBC, it is not an overlapping syndrome. Few studies to date have described this phenomenon. An 87-year-old woman was referred to our clinic with elevated serum alkaline phosphatase (714 U/L). She...
Source: Case Reports in Gastroenterology - January 6, 2023 Category: Gastroenterology Source Type: research
Endoscopic Laryngopharyngeal Surgery Combined with Endoscopic Submucosal Dissection as a Treatment Option for Superficial Hypopharyngeal Cancer with Suspected Synchronous Lymph Node Metastasis
We report 4 cases of hypopharyngeal cancer preoperatively suspected with synchronous lymph node metastases. Pathologic lymph node metastasis was confirmed in three of the four cases. All 4 cases underwent endoscopic laryngopharyngeal surgery (ELPS) combined with endoscopic submucosal dissection (ESD) and subsequent lymph node dissection as an optional treatment rather than the standard treatment. Peroral resection for primary site was selected because of the expected decline in quality of life (QoL) after radical surgery. Among 4 patients, one developed local recurrence; however, the other three remained recurrence-free an...
Source: Case Reports in Gastroenterology - January 3, 2023 Category: Gastroenterology Source Type: research
Understanding the Presentation of Terminal Ileitis
Our patient is a 47-year-old African American female with a past medical history of recurrent episodes of small bowel obstruction. She presented to the emergency department with symptoms of nausea, vomiting, and abdominal pain. Upon further evaluation, imaging showed obstruction at the terminal ileum. Based on the holistic clinical presentation, we initially thought that this patient was experiencing symptoms of early onset Crohn ’s disease. Gastroenterology evaluated the patient and was uncertain of the formal diagnosis. Colonoscopy and biopsy were not pathognomonic for Crohn’s disease, suggesting that there may be a ...
Source: Case Reports in Gastroenterology - December 27, 2022 Category: Gastroenterology Source Type: research
Impacted Common Bile Duct Stone Managed by Hepaticoduodenostomy
We present herein a hepaticoduodenotomy performed for a retained, impacted distal CBD stone in a low-resource setting with a good outcome. This impacted stone had complicated an open cholecystectomy for acute cholecystitis by causing the dehiscence of the cystic duct stump as a result of distal biliary obstruction.Case Rep Gastroenterol 2022;16:675 –679 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - December 21, 2022 Category: Gastroenterology Source Type: research
Diagnosis and Management of Lemmel Syndrome: An Unusual Presentation and Literature Review
We present the first case of Lemmel syndrome presenting as gastric outlet obstruction and provide the results of a systematic literature review.Case Rep Gastroenterol 2022;16:663 –674 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - December 16, 2022 Category: Gastroenterology Source Type: research
