Possible Development of Burn-Out Nonalcoholic Steatohepatitis under Long-Term Steroid Use
A 74-year-old man, who lived alone, was found in an unconscious state in his house by a neighbor after mail accumulated in his mailbox. He had asthma and nephrotic syndrome, which had been treated by prednisolone (10 mg) for more than 10 years, and steroid-induced DM. He had been obese since his 20s and had never drunk or smoked in his life. On arrival, he was obese and in a coma and shock state with respiratory failure. He therefore underwent rapid fluid resuscitation, tracheal intubation, mechanical ventilation, with cardiopressor treatment. Whole body computed tomography revealed atrophic liver and excess visceral fat. ...
Source: Case Reports in Gastroenterology - September 19, 2022 Category: Gastroenterology Source Type: research
Cholestatic Liver Injury in a Patient with Tertiary Syphilis
We report a rare case of a 64-year-old male with 3 weeks of abdominal pain, back pain, and neurologic deficits including memory impairment who was found to have neurosyphilis causing a cholestatic liver injury. Workup included a positive rapid plasma reagin (RPR) and enzyme immunoassay (EIA), a positive cerebrospinal fluid (CSF) venereal disease research laboratory (VDRL), and a liver biopsy, which was compatible with a diagnosis of syphilitic hepatitis. Completion of a 14-day course of penicillin and 1 month of physical therapy resulted in near full-functional and biochemical recovery.Case Rep Gastroenterol 2022;16:552 â€...
Source: Case Reports in Gastroenterology - September 19, 2022 Category: Gastroenterology Source Type: research
Heterotopic Pancreas in the Duodenum Diagnosed after Laparoscopic Biopsy
We report a case of a 31-year-old man who admitted to the hospital with the reason of epigastric pain for 3 days. Clinical examination showed mild epigastric tenderness. The past medical history of patient was unremarkable. A submucosal lesion was observed in the first part of the duoden um during endoscopy. Computed tomography and endoscopic ultrasonography findings were suspected to be heterotopic pancreatic tissue. After laparoscopic surgery for biopsy, it was histologically confirmed duodenal ectopic pancreas. It is difficult to differentiate gastrointestinal pancreatic heteroto pia from gastrointestinal stromal tumors...
Source: Case Reports in Gastroenterology - September 16, 2022 Category: Gastroenterology Source Type: research
Atypical Biliary Adenofibroma of the Liver: Related Treatment and Performance
Biliary adenofibroma is an extremely rare benign liver tumor, but it may be a precancerous lesion of cholangiocarcinoma. So far, only 29 cases have been reported in the literature. A 30-year-old woman was admitted to our department for upper abdomen mass. The computed tomography scan showed a huge cystic and partly substantial mass between the left lobe of the liver and the descending duodenum, which was considered to be an exophytic tumor derived from the left lobe of the liver. Laparoscopic liver segment IVb resection and cholecystectomy were performed. Microscopic examination showed that the tumor was composed of glandu...
Source: Case Reports in Gastroenterology - August 31, 2022 Category: Gastroenterology Source Type: research
Ischemic Colitis in a Patient with Severe COVID-19 Pneumonia
At the time of the current COVID-19 pandemic, on a daily basis, we encountered patients suffering from various manifestations of this infection. The most common are respiratory symptoms. Many of the patients require acute hospital care, and a smaller group of them are hospitalized in intensive care units. A subset of these critically ill patients demonstrates clinically remarkable hypercoagulability and thus a predisposition to venous and arterial thromboembolism, manifested by thrombotic events ranging from acute pulmonary embolism and splanchnic vascular ischemia to extremity ischemia. The article describes a case of a p...
Source: Case Reports in Gastroenterology - August 31, 2022 Category: Gastroenterology Source Type: research
Kikuchi-Fujimoto Disease in a Crohn ’s Patient
We report a unique case of KFD in a patient with coexisting Crohn ’s disease. Our patient is a 23-year-old African American female with a past medical history significant for Crohn’s disease who presented to the clinic because of a painless lump over the right side of the neck for the past 3 weeks. On physical examination, the patient was found to have enlarge d nontender right cervical lymph nodes from levels 2 to 4. An excisional biopsy of the right neck lymph node was done which revealed necrotizing histiocytic lymphadenitis, favoring a diagnosis of KFD. Over the course of the next 2 months, her lymphadenopathy got ...
Source: Case Reports in Gastroenterology - August 29, 2022 Category: Gastroenterology Source Type: research
Intramural Hematoma and Retroperitoneal Hematoma Following a Routine Colonoscopy: An Uncommon Complication of a Common Procedure
We present a case of intracolonic and retroperitoneal hematoma following a routine colonoscopy. This case highlights an uncommon life-threatening complication of a common procedure. A 50-year-old female presented with abdominal pain and syncopal episode following an uneventful screening colonoscopy. CT abdomen revealed intracolonic and retroperitoneal hematoma. This eventually led to exploratory laparotomy and right hemicolectomy after failure of conservative management. Clinicians need to be aware of the potentially life-threatening complications associated with colonoscopy for overall safety of colonoscopy.Case Rep Gastr...
Source: Case Reports in Gastroenterology - August 29, 2022 Category: Gastroenterology Source Type: research
Ischemic Necrosis of the Gastric Remnant Treated Successfully Using Total Remnant Gastrectomy
Distal gastrectomy (DG) with lymph node dissection is considered as the standard treatment for gastric cancer. Ischemic necrosis of the gastric remnant is a rare but serious complication of DG that requires careful consideration for early diagnosis and treatment to lower the associated mortality rate. A 71-year-old male presented to our hospital with hyperglycemia and was evaluated for suspected diabetes. The patient ’s medical history was otherwise unremarkable. Computed tomography (CT) revealed a thickening of the stomach wall, with follow-up esophagogastroduodenoscopy revealing type 3 gastric cancer in the greater cur...
Source: Case Reports in Gastroenterology - August 29, 2022 Category: Gastroenterology Source Type: research
Bowel Perforation in a Patient with Hepatocellular Carcinoma during Lenvatinib Treatment
We present a case of severe bowel perforation during lenvatinib treatment for advanced hepatocellular carcinoma. Although the Hartmann ’s procedure was performed, the patient died 48 h after the operation. The histopathological findings suggested that lenvatinib was involved in the etiology of bowel perforation in this case.Case Rep Gastroenterol 2022;16:502 –506 (Source: Case Reports in Gastroenterology)
Source: Case Reports in Gastroenterology - August 29, 2022 Category: Gastroenterology Source Type: research
Primary Gastrointestinal Follicular Lymphoma Exclusively Confined to the Mucosa
Follicular lymphoma (FL) is a common form of non-Hodgkin ’s lymphoma that rarely occurs in the gastrointestinal (GI) tract. The majority of GI FL cases are indolent in nature and are incidentally detected. They arise in the duodenum and more specifically near the ampulla of Vater. Multiple lesions are usually present upon endoscopic examination with muc osal and submucosal involvement. We hereby report the rare diagnosis of primary GI FL that presented as a solitary lesion exclusively involving the mucosal layer of the GI tract and was not located in the classic periampullary region of the duodenum, using a combination o...
Source: Case Reports in Gastroenterology - August 29, 2022 Category: Gastroenterology Source Type: research
Liver Abscess due to < b > < i > Streptococcus intermedius < /i > < /b > Bacteremia and Its Association with Colonic Carcinoma: Is Bacteremia with < b > < i > Streptococcus intermedius < /i > < /b > an Alert for Colonic Carcinoma?
Liver abscess caused by some kinds ofStreptococcus group such asStreptococcus bovis group has been recognized to associate with colorectal cancer.Streptococcus milleri group with liver abscess has not been received much attention in this point of view. Here, we report the case of a 63-year-old man who developed liver abscess withS. intermedius, which belongs to theS. milleri group. We confirmed that this case was accompanied by cecal carcinoma by colonoscopy. The tumor was a pathological lead point of intussusception of cecum. On the 26th day, open right hemicolectomy was performed. In this case, bacterial endophthalmitis ...
Source: Case Reports in Gastroenterology - August 19, 2022 Category: Gastroenterology Source Type: research
Laparoscopic Surgery for Intestinal Obstruction Caused by an Internal Paracecal Hernia
We present a case of incarcerated paracecal hernia with intestinal obstruction that was effectively treated with laparoscopic intervention. A 64-year-old woman who had not previously undergone any intestinal surgery arrived complaining of abdominal pain and vomiting at our hospital. Abdominal computed tomography suggested intestinal obstruction. A laparoscopic emergency procedure demonstrated an incarcerated small bowel loop in the paracecal region. The confined small bowel was removed from the paracecal area. On the fourth postoperative day, the patient was discharged. This case is unusual because the patient presented wi...
Source: Case Reports in Gastroenterology - August 19, 2022 Category: Gastroenterology Source Type: research
Right Colon Clear Cell Carcinoma of M üllerian Type
We report the case of a 75-year-old female patient who underwent surgery for a tumor of the ascending colon. Microscopic examination concluded an extensively necrotic carcinomatous growth which infiltrated all the layers of the intestinal wall and the peritoneum. The tumor was made of clu sters and spans of clear cells which were separated by thin conjunctivo-vascular septa. The tumor cells were round to polygonal with a clear, optically empty, pseudo-vegetative (physaliferous) cytoplasm. Immunohistochemistry study showed a positive staining with CK7 and a negative staining with CK20 , CDX2, PAX8, P63, CD10, chromogranin, ...
Source: Case Reports in Gastroenterology - August 19, 2022 Category: Gastroenterology Source Type: research
Very Delayed Perforation after Esophageal Endoscopic Submucosal Dissection and Intralesional Triamcinolone Injection
We report a case of delayed perforation following esophageal endoscopic submucosal dissection (ESD). A patient with Parkinson ’s disease presented with two superficial carcinomatous lesions in the middle third of the esophagus. ESD was performed, and 4/5 of the esophageal circumference was resected, including the adjacent lesion area. Immediately post-ESD, triamcinolone acetonide was injected into the submucosa underlyin g the ulcer to prevent scarring and stenosis. Histopathological examination of the resected specimen revealed squamous cell carcinoma limited to the lamina propria with negative margins. Seventeen days p...
Source: Case Reports in Gastroenterology - August 16, 2022 Category: Gastroenterology Source Type: research
Splenic Abscess due to a Perforated Duodenal Ulcer Successfully Treated with Endoscopic Ultrasound-Guided Transgastric Drainage
Splenic abscesses are rare, with a reported prevalence of 0.14 –0.7% in autopsy studies. The treatment options for splenic abscesses include intravenous antimicrobial therapy, percutaneous drainage, and splenectomy. Although the dissemination of endoscopic ultrasound (EUS) intervention techniques has made it possible to perform puncture and drainage via the t ransgastrointestinal route for intra-abdominal abscesses where the percutaneous route has been difficult, there have been few reports of EUS-guided drainage of splenic abscesses. A case of a splenic abscess associated with a perforated duodenal ulcer that was succes...
Source: Case Reports in Gastroenterology - August 16, 2022 Category: Gastroenterology Source Type: research
