Ahmad Alnasarat, Mostafa Elrazzaz, Nouraldeen Manasrah
{"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":"https://doi.org/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":"https://doi.org/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}
Hadi Farhat, Christie Dib, Yehya Tlaiss, Ayman Tabcheh, Pierre Hani
{"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}
Nikolaos Angelopoulos, William Beattie, Sern Wei Yeoh
{"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}
Jordan S Woodard, Jena Velji-Ibrahim, Jay Alden, Gary A Abrams
{"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}
{"title":"Cervical Chylous Leakage Combined With Chylothorax: A Case Report of a Rare Complication Postretroperitoneal Surgery and Its Management: A Case Report of Chylous Leakage.","authors":"Yao Zhou, Mingde Ding, Qiang Shi, Jing Wang, Guanghai Liu, Qianqian Zhang","doi":"10.1155/2024/8820322","DOIUrl":"https://doi.org/10.1155/2024/8820322","url":null,"abstract":"<p><p>Chylous leakage is an uncommon and serious clinical condition, especially occurring after retroperitoneal operations. Here, we report a case of cervical chylous leakage combined with chylothorax in a 57-year-old woman postretroperitoneal surgery, and our conservative approach led to resolution/clinical improvement. The causes of this rare complication are discussed. We considered that the venous thrombosis, the increased intra-abdominal pressure, or the patient positioning during the surgery may lead to the chylous particles leakage and chylothorax. Because of its rarity, we hope this case report will improve clinicians' understanding of cervical chylous leakage combined with chylothorax and provide suitable treatment options for future clinical reference.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2024 ","pages":"8820322"},"PeriodicalIF":0.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548197","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":"Rectal Adenocarcinoma With Pagetoid Spread: A Novel Entity.","authors":"Lefika Bathobakae, Pasha Shenasan, Aakash Trivedi, Ruhin Yuridullah, Sohail Qayyum, Abraham El-Sedfy","doi":"10.1155/2024/4952952","DOIUrl":"https://doi.org/10.1155/2024/4952952","url":null,"abstract":"<p><p>Perianal Paget's disease (PPD) is a rare skin adenocarcinoma that arises in the apocrine glands of the perianal region. It is often misdiagnosed as eczema, leukoplakia, squamous cell carcinoma, Bowen's disease, lichen planus, or condylomata acuminata. We report a case of a 63-year-old male who presented to the emergency room (ER) for evaluation of an anal mass that had persisted over 6 months. The patient was found to have a rectal adenocarcinoma with pagetoid spread and underwent neoadjuvant chemoradiation with symptom improvement. However, the patient declined further chemotherapy and the planned abdominal perineal resection with reconstruction, as it would require a permanent colostomy.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2024 ","pages":"4952952"},"PeriodicalIF":0.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548198","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":"White Globe Appearance-Like Findings Indicating Intralymphatic Cancer Involvement Beneath the Epithelium in Gastric Cancer.","authors":"Hiroki Maruyama, Taku Yamagata, Yoshihide Kanno, Takeshi Shimizu, Takuho Itasaka, Fumiyoshi Fujishima, Takashi Sawai, Kei Ito","doi":"10.1155/2024/8504987","DOIUrl":"10.1155/2024/8504987","url":null,"abstract":"<p><p>A 75-year-old female was diagnosed with a type 0-I, moderately differentiated, early gastric carcinoma on the posterior wall of the middle gastric body during esophagogastroduodenoscopy (EGD). Several small whitish structures, referred to as white globe appearances (WGAs), were noted on the oral side outside the demarcation line of the cancerous protrusion. Although this area was flat without cancerous mucosal changes on the surface, subepithelial cancer extension was suspected. The histopathology of the resected specimen revealed that the carcinoma with submucosal invasion had significant lymphatic invasion with submucosal lateral extent along lymphatic vessels. In some areas, the carcinoma within the lymphatic vessels regressed from the submucosal layer towards the mucosal lamina propria, penetrating the muscularis mucosas. The intralymphatic carcinoma reaching just beneath the epithelium was considered to manifest WGA features during endoscopy.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2024 ","pages":"8504987"},"PeriodicalIF":0.6,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510131","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}
Abdulrahman Qatomah, Simon McQueen, Wafa Qatomah, Aishah Qatomah, Ali Bessissow
{"title":"Fluoroscopic-Guided Removal of Jejunal Sharp Foreign Body: An Alternative Approach to Surgery.","authors":"Abdulrahman Qatomah, Simon McQueen, Wafa Qatomah, Aishah Qatomah, Ali Bessissow","doi":"10.1155/2024/5117360","DOIUrl":"10.1155/2024/5117360","url":null,"abstract":"<p><strong>Introduction: </strong>Foreign body (FB) ingestion represents a frequently encountered scenario in clinical practice. Most ingested FBs typically pass spontaneously, requiring no intervention. Endoscopic removal stands out as the least invasive method, with only a minimal 1% needing surgical intervention. <i>Case Presentation</i>. We present a case of a 30-year-old male who ingested multiple FBs located in the stomach and small bowel. While successful removal of the stomach FB was achieved through endoscopy, the second FB in the small bowel proved challenging due to perforation concerns and limited expertise. Given a history of prior surgical intervention resulting in a large incisional hernia, surgical removal was discouraged. Consequently, a collaborative decision involving surgeon and interventional radiologist (IR) led to the adoption of a fluoroscopic-guided removal approach facilitated by IR techniques.</p><p><strong>Conclusion: </strong>This case highlights the potential for a less invasive alternative in situations where both endoscopic and surgical interventions are deemed not feasible.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2024 ","pages":"5117360"},"PeriodicalIF":0.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11419835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308741","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}