A Novel Treatment Approach to Treatment-Resistant, Recurrent < i > Clostridium difficile < /i >
A 36-year-old male with a previous medical history of persistentClostridium difficile presented to clinic for evaluation of diarrheal symptoms intermittently for the last 2 years. He reported recurrent episodes ofC. difficile that initially began after prophylactic antibiotic use prior to a tooth extraction. He underwent 12 unsuccessful treatment trials at a nearby clinic with courses of vancomycin, metronidazole, and fidaxomicin. His chronic diarrhea had caused him to endure significant lifestyle alterations over the years. After multiple episodes of incomplete bacterial clearance, he was referred to a university-based te...
Source: Case Reports in Gastroenterology - December 5, 2022 Category: Gastroenterology Source Type: research
Mixed Neuroendocrine Non-Neuroendocrine Neoplasm Arising in the Ectopic Gastric Mucosa of Esophagus
We report a rare case featuring endoscopic submucosal dissection (ESD) for an esophageal MiNEN, arising from the ectopic gastric mucosa in the lower thoracic esophagus. A 92-year-old male patient was referred to this hospital for investigation of an esophageal tumor. An endoscopic examination revealed a 10 mm elevated lesion, with 8 mm flat areas on the anal side, within the ectopic gastric mucosa located in the lower thoracic esophagus. ESD was carried out, and a histopathological examination revealed a tubular adenocarcinoma composed of differentiated neuroendocrine cells. Immunohistochemical staining was positive for sy...
Source: Case Reports in Gastroenterology - December 5, 2022 Category: Gastroenterology Source Type: research
Left Perforated Colonic Tumor with Synchronous Locally Advanced Right Colonic Tumor
Colorectal cancer is one of the most common malignant neoplasms worldwide. Overall mortality is 33%. Synchronous colorectal cancer refers to more than one malignant tumor detected in different segments of the colon, simultaneously or within 6 months of initial diagnosis. The development of colorectal cancer is a multistep process that originates with a genetic mutation leading to a malignant phenotype and generating a growth advantage. Colorectal cancer presents up to 16% of hypermutations, of which 75% are characterized by microsatellite instability which in turn leads to poorer cell differentiation. Patients with synchro...
Source: Case Reports in Gastroenterology - December 5, 2022 Category: Gastroenterology Source Type: research
Efficacy of Infliximab for the Treatment of Oral Manifestation of Crohn ’s Disease
Oral manifestations of IBD can be specific or nonspecific, due to intestinal malabsorption or induced by pharmacological treatments. Oral manifestations may precede the diagnosis of IBD or interfere with timely diagnosis and treatment. The paradigm of treatment for oral lesions in patients with IBD is based on treating and controlling the intestinal manifestations of the underlying disease as well as local methods of treatment can be used. Here, we report a case of a patient with the oral manifestation of IBD, who responded to treatment with infliximab. The patient was admitted with complaints of long-term nonhealing ulcer...
Source: Case Reports in Gastroenterology - November 28, 2022 Category: Gastroenterology Source Type: research
Microscopic Colitis with Escitalopram Use and New Onset Vitiligo
Microscopic colitis is a common cause of chronic diarrhea, particularly in patients with autoimmune disorders. Colonic mucosa appears normal and only shows inflammation on histological examination. There are two histological variations of microscopic colitis. It has been associated with several drug classes, and certain drugs are associated with one variation or another. In this case report, we discuss the case of a patient who is on a drug not previously associated with her variation of microscopic colitis and who has an autoimmune condition whose relationship to microscopic colitis is not well studied. We aim to outline ...
Source: Case Reports in Gastroenterology - November 28, 2022 Category: Gastroenterology Source Type: research
Diffuse Metastatic Melanoma in the GI Lumen Following Immune Checkpoint Inhibitor Colitis Treatment
We describe the unique case of a 73-year-old man who developed diffuse metastatic melanoma throughout the GI tract following potent immunosuppressive treatment for his immune-mediated colitis. Diagnosis of his metastatic GI luminal disease was confirmed with colonoscopy and EGD biopsies. Immunosuppressive therapy including corticosteroids and vedolizumab is the mainstay treatment for immune-mediated colitis and has generally been thought to have a safe toxicity profile. This unique case of diffuse luminal metastasis of melanoma after intensive immunosuppressant treatment raised the concern of their long-term safety on the ...
Source: Case Reports in Gastroenterology - November 8, 2022 Category: Gastroenterology Source Type: research
Drug-Induced Liver Injury from Herbal Liver Detoxification Tea
We describe the case of a 36-year-old female who developed a clinically significant acute liver injury with a cholestatic pattern due to an over-the-counter herbal liver detox tea. This is the first case reported of a hepatotoxic effect from any of these compounds or ingredients in the detox tea: burdock root, stinging nettle leaf, cleavers herb, dandelion root, lemon peel, and lemon myrtle leaf (Backhousia citriodora). Idiosyncratic drug-induced liver injury (DILI) remains poorly understood; however, recognizing potential toxins is imperative to understanding toxicogenomics and identifying those at risk.Case Rep Gastroent...
Source: Case Reports in Gastroenterology - November 8, 2022 Category: Gastroenterology Source Type: research
Esophago-Pleural Fistula Complicating a Laparoscopic Adjustable Gastric Band
We present a case of an esophago-pleural fistula complicating a longstanding laparoscopic adjustable gastric band in a woman presenting with persistent empyema. Palliative esophageal stenting was successfully performed, and the patient was discharged home on hospice care per her family ’s wishes.Case Rep Gastroenterol 2022;16:607 –611 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - November 8, 2022 Category: Gastroenterology Source Type: research
Gastrointestinal Bleeding from Dieulafoy ’s Lesion in the Cecum
Dieulafoy ’s lesion is a rare cause of gastrointestinal (GI) bleeding comprising approximately 2% of all acute GI bleeds. It is an abnormal submucosal artery that has a tortuous course before protruding through the mucosa and leading to hemorrhage. Dieulafoy’s lesions are most commonly located in the uppe r GI tract within the lesser curvature of the stomach. Lower GI tract Dieulafoy’s lesions are remarkably rare. Our case describes an elderly gentleman who presented with fatigue and dyspnea several days prior to experiencing any evidence of GI bleeding. Initial laboratory investigation revealed se vere anemia, requi...
Source: Case Reports in Gastroenterology - November 8, 2022 Category: Gastroenterology Source Type: research
Recurrent Cholangitis Secondary to a Traumatic Biliary Neuroma
We present a case of biliary neuroma arising from a recent laparoscopic cholecystectomy, complicated by bile leak and recurrent cholangitis. An extensive review of the literature was performed, closely examining related etiology, trends in age, clinical symptomology, and time to presentation. The role of surgery compared to an endoscopic approach in diagnosis has been reviewed. Physicians are urged to remain mindful of malignant biliary strictures as they may easily mimic and misguide the diagnosis of a traumatic biliary neuroma.Case Rep Gastroenterol 2022;16:595 –600 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - November 8, 2022 Category: Gastroenterology Source Type: research
Primary Peritoneal Mesothelioma: Diagnostic Challenges of This Lethal Imposter
Primary Peritoneal Mesothelioma is a rapidly aggressive and rare neoplasm that arises from the lining of mesothelial cells of the peritoneum and spreads extensively within the confines of the abdominal cavity. The pathogenesis of all forms of mesothelioma is strongly associated with industrial pollutants, of which asbestos is the principal carcinogen. Characteristically, asbestos exposure has a strong relationship with mesothelioma of the pleura, but the peritoneal cavity is the second most commonly affected site. Additionally, in contrast to pleural mesothelioma, which has a male predominance (male-female ratio of between...
Source: Case Reports in Gastroenterology - November 8, 2022 Category: Gastroenterology Source Type: research
Treatment Outcome of Endoscopic Ultrasound Radiofrequency Ablation for Incidentaloma Pancreatic Neuroendocrine Tumor in Young Female Patient: A 2-year Follow-Up
In conclusion, EUSRA can be an alternative option for incidentaloma of NF-PNET management.Case Rep Gastroenterol 2022;16:583 –587 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - November 7, 2022 Category: Gastroenterology Source Type: research
Primary Localized Small Bowel Amyloidosis: A Rare Cause of Diarrhea Detected by Balloon-Assisted Enteroscopy
Gastrointestinal involvement occurs in approximately 4% of cases of systemic amyloidosis and may be associated with heterogeneous and nonspecific clinical manifestations and endoscopic findings, which poses important diagnostic challenges. A 76-year-old female with previous medical history of breast cancer, hypertension, dyslipidemia, asthma, and depression presented to emergency department with a 1-month history of diarrhea, abdominal pain, anorexia, asthenia, and weight loss. Physical examination revealed dehydration and abdominal tenderness. Stool microbiologic studies,Clostridium difficile toxin, fecal leukocyte count,...
Source: Case Reports in Gastroenterology - November 2, 2022 Category: Gastroenterology Source Type: research
Clinicopathological Features of Early-Stage Esophageal Carcinosarcoma
Esophageal carcinosarcoma (EC) is a rare malignant tumor, accounting for 0.5 –2.8% of esophageal cancers. Most are advanced cancers that are detected as polypoid lesions and are treated with multidisciplinary therapy with a focus on surgery. However, endoscopic findings, pathological findings, and long-term outcomes of early-stage EC are often unclear because there are ver y few reported cases. This paper reports three cases of EC confined to the mucosal layer. The macroscopic type of all tumors was polypoid lesion with a slightly depressed lesion. All cases were clinically diagnosed as invasive cancer before treatment. ...
Source: Case Reports in Gastroenterology - November 2, 2022 Category: Gastroenterology Source Type: research
Curcumin-QingDai Combination as Treatment for Moderate-Severe Ulcerative Colitis
We report on the use of curcumin-QingDai combination (CurQD) for the treatment of moderate-severe UC. Patient 1 was a 24-year-old male with severe UC refractory to cyclosporine and corticosteroids. He partially responded to infliximab but later lost response to an optimized dose of infliximab in combination with 6-mercaptopurine, presenting with worsening symptoms and severe Mayo 3 mucosal inflammation. Initiation of CurQD 2.5 g/day resulted in rapid cessation of blood per rectum. Complete clinical remission ensued within few weeks. Follow-up endoscopies performed 12 weeks later showed only minimal residual inflammation. I...
Source: Case Reports in Gastroenterology - September 20, 2022 Category: Gastroenterology Source Type: research
