Case Reports in Gastrointestinal Medicine最新文献

{"title":"Disseminated Chickenpox Following Live Varicella Vaccination in a Crohn's Disease Patient on Combination Immunosuppression.","authors":"Quintin Solano, Sarah Uttal, Peter D R Higgins, Jeffrey A Berinstein","doi":"10.1155/crgm/6088333","DOIUrl":"https://doi.org/10.1155/crgm/6088333","url":null,"abstract":"<p><p>Novel therapeutics used in the treatment of inflammatory bowel disease pose an increased risk of viral reactivation in patients. We present a case of a patient with refractory Crohn's disease (CD) who developed primary varicella (chickenpox) of a vaccine-viral strain after receiving combination immunosuppression with high-dose corticosteroids, tumor necrosis factor inhibitor (TNFi), and a Janus kinase inhibitor (JAKi) in the hospital. While this patient recovered and did not experience long term adverse effects, her case provides an opportunity for improvement. To improve safety, healthcare facilities should develop protocols that use electronic medical records enhanced with clinical decision support systems to identify and protect immunocompromised patients from inappropriate live vaccinations.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"6088333"},"PeriodicalIF":0.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Typhoid Fever as a Cause of Liver Failure in the United States: A Case Report.","authors":"Syed Mujtaba Baqir, Neha Sharma, Aruge Lutaf, Monica Ghitan, Yu Shia Lin","doi":"10.1155/crgm/3087201","DOIUrl":"10.1155/crgm/3087201","url":null,"abstract":"<p><p><b>Background:</b> Typhoid fever is a multisystemic illness caused by <i>Salmonella typhi</i> and <i>Salmonella paratyphi</i>, transmitted fecal orally through contaminated water and food. It is a rare diagnosis in the US, with most cases reported in returning travelers. Hepatitis and cholestasis are rare sequelae of <i>salmonella</i> infection. However, acute liver failure (ALF) is exceptionally uncommon. We report a case of typhoid fever in a returning traveler to the US progressing to ALF. <b>Case Presentation:</b> A 48-year-old man presented with high-grade fever, abdominal pain, vomiting, acholic stools, dark urine, and yellowish discoloration of skin and sclera for one week. He was immune to hepatitis A and B, with no recent change in medications. He had no history of alcohol consumption. On presentation, the patient was tachycardic but well perfused with diffuse abdominal tenderness. Laboratory results showed leukocytosis, elevated creatinine, mixed hepatocellular and cholestatic pattern of raised liver enzymes, elevated ammonia levels, and negative hemolytic parameters. Viral, autoimmune, and metabolic causes of hepatitis were negative. Ultrasound of the abdomen revealed a normal biliary system and a computerized tomography (CT) scan of the abdomen showed multiple liver cysts, mesenteric and porta-hepatis lymphadenopathy, and mild thickening of the terminal ileum. Intravenous (IV) ceftriaxone and metronidazole were initiated. Blood cultures grew <i>S</i>. <i>typhi</i>. The patient clinically deteriorated and developed altered mental status, respiratory distress, and an up-trending Model for End-Stage Liver Disease (MELD) score and was upgraded to the intensive care unit. IV meropenem was initiated, resulting in clinical recovery and negative repeat blood cultures. The patient completed 2 weeks of meropenem and was discharged. <b>Conclusion:</b> Typhoid fever can cause life-threatening liver failure which is rare. Clinicians should be aware of this due to the rapid progression and life-threatening clinical course, as well as the rise of multidrug-resistant and extensively drug-resistant typhoid causing delays in starting the right antibiotic.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"3087201"},"PeriodicalIF":0.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Colorectal Cancer With Delayed Metastasis to the Duodenum.","authors":"Ammad Javaid Chaudhary, Abdulmalik Saleem, Muhammad Shahzil, Nosheen Hafeez, Taher Jamali, Brian Ginnebaugh","doi":"10.1155/crgm/6679555","DOIUrl":"10.1155/crgm/6679555","url":null,"abstract":"<p><p>Colorectal cancer (CRC) continues to be a significant global health issue contributing to a high mortality rate. Despite advancements in treatment, the risk of recurrence remains due to inherent mutations and the rapid turnover of intestinal mucosa. We present an exceptionally rare case of CRC metastasis to the duodenum in a 42-year-old female who has been compliant with postsurgical surveillance. Despite previous negative surveillance results, elevated CEA levels and a 3-cm mesenteric mass were detected, raising concerns for carcinoma, which was later confirmed by biopsy. The tumor board deemed her ineligible for surgery due to vascular involvement, leading to palliative care and an attempt at neoadjuvant therapy. Vigilant monitoring is crucial for early detection and intervention.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"6679555"},"PeriodicalIF":0.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic View of the Aorta Through the Oesophagus: An Unusual Complication Post Thoracic Endovascular Aortic Repair.","authors":"Kushedison Yunus, Hasib Ahmadzai, Eleanor Noreen Dunlop, Andrew Thomson","doi":"10.1155/crgm/6277906","DOIUrl":"10.1155/crgm/6277906","url":null,"abstract":"<p><p>We present a case of an 80-year-old female who presented with chest pain, vomiting and night sweats a few weeks post thoracic endovascular aortic aneurysm repair (TEVAR). A computed tomography (CT) scan demonstrated a type 1B endoleak for which she underwent a repeat TEVAR. Postoperatively, she developed fever, dysphagia, haematemesis and melaena. CT angiography subsequently confirmed an aorto-oesophageal fistula (AEF). Gastroscopy was performed to confirm this and found an ovoid oesophageal perforation with visible aortic graft and purulent fluid. Serial endoscopic oesophageal stents were placed and the patient recovered after an oesophageal Ultraflex stent was placed. Unfortunately, however, the patient was found unresponsive at home with black vomitus and in cardiac arrest and passed away 18 months after her initial endoscopic procedure. This case highlights that AEF is a complication following a TEVAR procedure. This can be managed temporarily with oesophageal stent placement and an Ultraflex stent in the longer term. However, oesophageal stent placement is not curative in cases of significant oesophageal perforation as it does not lead to lead to closure of a large defect.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"6277906"},"PeriodicalIF":0.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Challenging Case of Recurrent Ogilvie Syndrome: Exploring Causes and Treatment Modalities.","authors":"Ahmad Alnasarat, Mostafa Elrazzaz, Nouraldeen Manasrah","doi":"10.1155/crgm/5378390","DOIUrl":"10.1155/crgm/5378390","url":null,"abstract":"<p><p><b>Introduction:</b> Acute colonic pseudo-obstruction (ACPO), or Ogilvie syndrome, is a rare condition marked by significant colon distention without mechanical obstruction. Symptoms include abdominal pain, bloating, nausea, vomiting, and an inability to pass gas or stool. Although common in males over 60, we report a challenging case of a 44-year-old man from Africa with recurrent abdominal distention and discomfort. Ultimately, he improved after receiving multiple treatment modalities, highlighting the complexities of Ogilvie syndrome management. <b>Case Presentation:</b> A 44-year-old Nigerian male in the United States with hypertension and significant alcohol use disorder presented with altered mental status and bilateral lower extremity weakness after fasting and hydrochlorothiazide abuse. Initial diagnostics indicated metabolic encephalopathy from hypokalemia and dehydration. Despite aggressive treatment, he developed severe abdominal distension and obstipation. A CT scan showed diffuse colonic dilatation without a normal small bowel. Conservative measures failed, necessitating ICU transfer, TPN, and empiric antibiotics. Despite an initial response to colonoscopy decompression, the patient experienced recurrence. Neostigmine significantly improved his condition, leading to full recovery and discharge. <b>Conclusion:</b> This challenging case highlights the complexities of managing Ogilvie syndrome and the importance of early identification and a stepwise approach to treatment. Incorporating a patient-centered plan utilizing conservative measures, pharmacological agents and endoscopic interventions are essential for improving outcomes in these cases.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2024 ","pages":"5378390"},"PeriodicalIF":0.6,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Esophageal Rhabdomyosarcoma: An Exceptionally Rare Cause of Pediatric Dysphagia.","authors":"Maryam Ataollahi, Amirali Mashhadiagha, Fereshteh Karbasian, Reza Moshfeghinia, Javad Arabpour, Bita Geramizadeh","doi":"10.1155/crgm/3648155","DOIUrl":"10.1155/crgm/3648155","url":null,"abstract":"<p><p><b>Background:</b> Esophageal embryonal rhabdomyosarcoma (ERMS), a rare pediatric cancer, mimicked achalasia in a case involving dysphagia and vomiting. Diagnosis and chemotherapy necessitate careful monitoring due to potential complications. <b>Case presentation:</b> A 12-year-old girl with no prior medical history presented with progressive dysphagia and vomiting. Initial diagnosis suggested achalasia, but further evaluation revealed a large mediastinal mass causing esophageal compression. Biopsies confirmed primary ERMS of the esophagus with metastases. Despite chemotherapy, she developed complications, including neutropenic enterocolitis and posterior reversible encephalopathy syndrome (PRES). Unfortunately, she succumbed to neutropenic sepsis. <b>Conclusion:</b> In this case study, we presented our experience regarding the clinical course of this disease, treatment strategy, and prognosis, in addition to the limited previous information in the literature.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2024 ","pages":"3648155"},"PeriodicalIF":0.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Autoimmune Pancreatitis in a 9-Year-Old Male Patient: A Comprehensive Diagnosis and Successful Treatment.","authors":"Hadi Farhat, Christie Dib, Yehya Tlaiss, Ayman Tabcheh, Pierre Hani","doi":"10.1155/crgm/5564385","DOIUrl":"10.1155/crgm/5564385","url":null,"abstract":"<p><p>Autoimmune pancreatitis (AIP) is a rare and complex condition that can be difficult to identify due to its resemblance to malignancies. This case report presents a unique instance of AIP in a 9-year-old male patient who presented with painless jaundice and elevated liver function test results. His symptoms were persistent even after previous common bile duct stent placement, requiring additional investigation. The possibility of AIP was raised by further serological tests and imaging examinations. The diagnosis was then confirmed by multiple characteristic findings revealed through history, imaging, clinical examination, histology, and lab results. Treatment was initiated with corticosteroids, which resulted in a complete resolution of symptoms and remarkable recovery. This case emphasizes the significance of including AIP in the differential diagnosis of pancreatic disorders, even in pediatric patients.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2024 ","pages":"5564385"},"PeriodicalIF":0.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jejunal Diverticular Bleeding on Long-Term Aspirin and Short-Term Corticosteroid Therapy.","authors":"Nikolaos Angelopoulos, William Beattie, Sern Wei Yeoh","doi":"10.1155/crgm/8875482","DOIUrl":"https://doi.org/10.1155/crgm/8875482","url":null,"abstract":"<p><p>Haemorrhage is one of the most common complications of jejunal diverticula, which is a challenge to diagnose as the anatomical location of the jejunum renders it inaccessible to standard upper endoscopy, while routine imaging modalities may miss subtle or intermittent bleeding. Male gender, increasing age and colonic diverticula are known risk factors for jejunal diverticula. Nonsteroidal anti-inflammatory drugs and corticosteroids increase gastrointestinal bleeding risk. We present a case of an 80-year-old male admitted to our hospital with syncope and melaena, in the setting of colonic diverticula, long-term aspirin and short-term corticosteroid therapy. Push enteroscopy, using a paediatric colonoscope, was pivotal to establishing the diagnosis of jejunal diverticular bleeding after gastroduodenoscopy and computed tomography (CT) angiogram were negative. Management was conservative with repeat push enteroscopy confirming the cessation of bleeding. Clinicians should consider this diagnosis when there are clinical signs of gastrointestinal bleeding in patients with known risk factors for jejunal diverticula and no evidence of location on gastroduodenoscopy, colonoscopy or imaging. We advise that push enteroscopy is performed early during the diagnostic workup to assist in identifying jejunal sources of bleeding and initiating management. However, as reflected by our case, jejunal diverticular haemorrhage may be amenable to conservative measures.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2024 ","pages":"8875482"},"PeriodicalIF":0.6,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Cholecystectomy for Gall Bladder Volvulus: A Report of an Original Case With Review of Literature.","authors":"Ayad Ahmad Mohammed","doi":"10.1155/2024/9319605","DOIUrl":"https://doi.org/10.1155/2024/9319605","url":null,"abstract":"<p><p><b>Background:</b> Volvulus of gallbladder is defined as a rotation of the gallbladder on its mesentery along the axis of the cystic duct and cystic artery. Many factors are postulated to be the causes such as anatomical, mechanical, physiological, and hormonal risk factors but the presence of a distended gallbladder with a redundant mesentery is thought to be an important cause. <b>Case presentation:</b> A 68-year-old woman presented with right hypochondrial pain and vomiting for 2 days that was radiated to the interscapular region and associated with nausea and vomiting. The patient had no jaundice and the abdominal examination showed severe tenderness with guarding during palpation of the right upper abdomen with no palpable mass. The WBCs were elevated, with normal liver enzymes, bilirubin, and alkaline phosphatase. The ultrasound showed a single gallstone with increased wall thickness. There was no significant clinical improvement with antibiotics and analgesics. During laparoscopy, volvulus of the gallbladder was discovered causing gangrene of the gallbladder. Laparoscopic detorsion and successful laparoscopic cholecystectomy were performed. The patient was discharged on the third postoperative day with dramatic improvement with no postoperative complications. <b>Conclusion:</b> Gall bladder volvulus is an acute surgical emergency that is usually seen in the elderly population. It required a high index of suspicion especially in the absence of gallstones and must be differentiated from acalculous cholecystitis. Most cases are discovered at surgery. It must be managed with immediate detorsion and cholecystectomy, and the prognosis is excellent in most cases after an appropriate surgical intervention.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2024 ","pages":"9319605"},"PeriodicalIF":0.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VCTE Overestimates Liver Fibrosis due to Abdominal-Truncal Adiposity and Not Hepatic Steatosis: A Case Report.","authors":"Jordan S Woodard, Jena Velji-Ibrahim, Jay Alden, Gary A Abrams","doi":"10.1155/2024/7938701","DOIUrl":"10.1155/2024/7938701","url":null,"abstract":"<p><p>Vibration-controlled transient elastography (VCTE) is used for the noninvasive assessment of liver fibrosis. We present a case of significant weight loss over 1 year, resulting in a marked improvement in liver stiffness suggesting a decrease in liver fibrosis from stage 4 (cirrhosis) to stage 2 (moderate fibrosis) notably without a change in the grade of hepatic steatosis. The improvement in two stages of fibrosis over this short time frame is due to the overestimation of liver stiffness in a subject with class 3 obesity and not due to the resolution of fibrosis. Therefore, this case highlights that BMI, due to excess subcutaneous abdominal adipose tissue and not intrahepatic lipid accumulation, can cause a significant overestimation of liver fibrosis with VCTE.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2024 ","pages":"7938701"},"PeriodicalIF":0.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}