{"title":"A Rare Association: Hereditary Hemorrhagic Telangiectasia with Liver Cirrhosis Causing Portal Hypertension.","authors":"Denisse Morales-Tovar, Froylan D Martínez-Sánchez, Alejandro Gabutti-Thomas, Rodolfo Rivera-Martínez, Jacqueline Córdova-Gallardo","doi":"10.1155/2024/3574725","DOIUrl":"10.1155/2024/3574725","url":null,"abstract":"<p><p>Hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is a vascular disorder of autosomal dominant etiology. The hallmark clinical feature is the presence of recurrent episodes of epistaxis in patients with vascular malformations and a tendency to bleed. We present the case of a 71-year-old woman who presented to the emergency department with upper gastrointestinal bleeding caused by esophageal varices, in conjunction with gastric angiodysplasias. The presence of oronasopharyngeal telangiectasias and hepatomegaly raised suspicion of HHT. The diagnostic workup confirmed the presence of angiodysplasia in the gastric region, portal arteriovenous malformation, and a pulmonary shunt.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2024 ","pages":"3574725"},"PeriodicalIF":0.6,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10807975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565093","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":"Refractory Cytomegalovirus Colitis in Common Variable Immunodeficiency Requiring Total Colectomy","authors":"Sulaiman Almushir, Faisal Aljohani, A. Qatomah","doi":"10.1155/2023/8888429","DOIUrl":"https://doi.org/10.1155/2023/8888429","url":null,"abstract":"Cytomegalovirus (CMV) colitis is an uncommon infection in immunocompetent hosts, usually occurring in the presence of an underlying immunodeficiency condition that allows for the reactivation of latent CMV infection. CMV colitis typically presents with persistent diarrhea, sometimes accompanied by bloody stools and nonspecific abdominal pain. We present the case of a 76-year-old woman known to have chronic CMV colitis, which was diagnosed in the context of underlying common variable immunodeficiency (CVID). Despite multiple attempts at managing CMV colitis, her symptoms persisted over the years. Ultimately, the patient required a pan colectomy due to refractory CMV colitis.","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"31 5","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138948548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Case Report and Literature Review of a Rare Jejunal Solitary Peutz–Jeghers-Type Polyp Resected Endoscopically in an Elderly Patient Presenting with Subacute Gastrointestinal Bleeding","authors":"Talal Alenezi, Victoria Marcus, T. Bessissow","doi":"10.1155/2023/2391602","DOIUrl":"https://doi.org/10.1155/2023/2391602","url":null,"abstract":"Solitary Peutz–Jeghers-type polyp (SPJP) is a rare hamartomatous lesion. It is considered a different entity from Peutz–Jeghers syndrome despite similar histopathological findings. It can be found in the GI tract but rarely in the jejunum. Jejunal SPJP is susceptible to necrosis, ulceration, and intussusception, resulting in GI bleeding or small bowel obstruction. We describe a case of subacute gastrointestinal bleeding secondary to jejunal SPJP to share our approach to this challenging case using therapeutic endoscopy. An 81-year-old male patient with a history of atrial fibrillation on warfarin with stable therapeutic INR levels presented with a 1-week history of melena, generalized fatigue, and shortness of breath on exertion and was found to have profound iron deficiency anemia. Esophageal gastroduodenoscopy and colonoscopy failed to identify the source of bleeding; however, single-balloon enteroscopy detected a 4 cm polyp with a stalk in the proximal jejunum. Endoscopic polypectomy was performed, and the whole polyp was removed. Histopathological examination was consistent with Peutz–Jeghers polyp. The genetic analysis was negative for STK11 mutation. Follow-up magnetic resonance enterography and video capsule endoscopy did not reveal any other polypoid lesion in the GI tract. The patient’s symptoms resolved gradually, and his hemoglobin level returned back to normal levels within 6 months. To our knowledge, this is the first case of endoscopic polypectomy during balloon-assisted enteroscopy for jejunal SPJP.","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"52 s180","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138995338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dermatofibrosarcoma Protuberans (DFSP) with Fibrosarcomatous Changes in a Patient with Crohn's Disease Treated with Anti-TNF (Adalimumab).","authors":"Ivo Klarin","doi":"10.1155/2023/1057247","DOIUrl":"10.1155/2023/1057247","url":null,"abstract":"<p><p>Dermatofibrosarcoma protuberans (DFSP) is a low-to-intermediate grade sarcoma with a reported incidence of 4.1 per million person-years. Despite its local invasiveness, it rarely metastasizes (5% of cases). Fibrosarcomatous change in DFSP is a form of tumor progression that carries an increased risk of metastases. We reported a case of 45-year-old patient treated with adalimumab lasting 7 years for Crohn's disease who developed dermatofibrosarcoma protuberans with fibromatous changes. Adalimumab therapy was stopped before surgery, and ustekinumab was introduced 6 months after.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"1057247"},"PeriodicalIF":0.6,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10581855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683381","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":"Transient Intussusception Mimicking Acute Coronary Syndrome.","authors":"Hiroshi Imamura, Yuichiro Kashima, Yujiro Hamano, Aoi Ogawara","doi":"10.1155/2023/7324188","DOIUrl":"10.1155/2023/7324188","url":null,"abstract":"<p><p>Intussusception in adults is rare and usually associated with organic lesions. However, in the current era of computed tomography (CT), cases of idiopathic and transient intussusceptions are being increasingly diagnosed. Herein, we present a case of ileocecal intussusception with symptoms mimicking those of acute coronary syndrome. A male patient in his 80s with a history of myocardial infarction presented to the emergency department with acute onset of severe precordial and epigastric pain, cold sweating, and vomiting. Coronary angiography did not reveal any significant new lesion, while abdominal CT revealed ileocecal intussusception without bowel obstruction. The pain spontaneously subsided without any intervention, and the patient was discharged on the sixth hospital day. Cases of intussusception may go unnoticed in patients suspected of having chest pain with a normal coronary arteriogram, as idiopathic intussusception is relatively common and subsides spontaneously. Therefore, physicians should note that intussusception is one of the differential diagnoses of acute coronary syndrome.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"7324188"},"PeriodicalIF":0.7,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239730","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}
Xiaolan Tang, Anuoluwa Oyetoran, Tyler Jones, Christopher Bray
{"title":"<i>Aeromonas caviae</i>-Associated Severe Bloody Diarrhea.","authors":"Xiaolan Tang, Anuoluwa Oyetoran, Tyler Jones, Christopher Bray","doi":"10.1155/2023/4966879","DOIUrl":"10.1155/2023/4966879","url":null,"abstract":"<p><p><i>Aeromonas</i> species are capable of inducing severe infections in both immunocompetent and immunocompromised individuals. Gastroenteritis is the most common infection associated with <i>Aeromonas</i> species in humans. We report a rare case of <i>Aeromonas caviae</i> severe gastroenteritis and bloody diarrhea that led to the development of sepsis in a 45-year-old female with no history of immunocompromising conditions. This patient required extensive medical support which included blood transfusions and antibiotics. Fortunately, with appropriate diagnostic measures and targeted antibiotic therapy, her symptoms resolved. <i>Aeromonas</i> species are becoming increasingly frequent among the pathogens isolated from patients suffering from gastroenteritis. As such, it is becoming increasingly important for clinicians to consider this pathogen when working up their patients for diarrhea.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"4966879"},"PeriodicalIF":0.7,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239729","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}
Sobaan Taj, Chris Austin, Azhar Hussain, Maryam Salma Babar, Harshavardhan Sanekommu, Steven Imburgio, Anmol Johal, Alejandro CruzPonce, Apurva Vedire, Edward Liu
{"title":"Severe Gastrointestinal Hemorrhage due to Monkeypox Virus-Associated Proctocolitis.","authors":"Sobaan Taj, Chris Austin, Azhar Hussain, Maryam Salma Babar, Harshavardhan Sanekommu, Steven Imburgio, Anmol Johal, Alejandro CruzPonce, Apurva Vedire, Edward Liu","doi":"10.1155/2023/9981631","DOIUrl":"https://doi.org/10.1155/2023/9981631","url":null,"abstract":"<p><p>Monkeypox is primarily a painful cutaneous disease with occasional systemic manifestations. Monkeypox is transmitted predominantly through close physical contact and occasionally sexual contact. The first case was reported in the United States on May 17, 2022, in a recent monkeypox worldwide outbreak. We present a case of severe gastrointestinal bleeding as an atypical manifestation of monkeypox infection in a 40-year-old male with HIV. In our case, monkeypox-induced proctocolitis progressed to severe rectal bleeding requiring one unit of packed red blood cells transfusion despite one week of tecovirimat (TPOXX) therapy. So, patients should be educated about the possibility of unusual complications of monkeypox infection, i.e., bleeding in immunocompromised hosts.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"9981631"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10365909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233485","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":"Gastrointestinal Stromal Tumours (GISTs) with KRAS Mutation: A Rare but Important Subset of GISTs.","authors":"Dorinda Mullen, Rajkumar Vajpeyi, Jose-Mario Capo-Chichi, Klaudia Nowak, Newton Wong, Runjan Chetty","doi":"10.1155/2023/4248128","DOIUrl":"https://doi.org/10.1155/2023/4248128","url":null,"abstract":"<p><p>Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the GI tract, usually found in the stomach, jejunum, and ileum. Typically, they are <i>KIT</i> or <i>PDGFR</i>-mutated, allowing for targetable treatments with tyrosine kinase inhibitors such as imatinib. Here, we present two <i>KRAS</i>-mutated wild-type gastrointestinal tumours (GISTs). Both cases occurred in the small bowel of females. Immunohistochemical studies on both tumours showed KIT and DOG-1 positivity, with SDHB retained. Molecular analysis revealed a <i>KRAS G12D</i> mutation and a <i>KRAS G13D</i> mutation, respectively. Wild-type GISTs are extremely uncommon. They typically occur in the stomach or the small bowel. <i>KRAS</i> is one of the genes implicated in this subset of GIST, with <i>KRAS G12D</i> being the most frequently encountered mutation. GIST <i>KRAS</i> mutations can arise alone or in conjunction with <i>KIT, PDFRA</i>, or <i>BRAF</i> mutations. Identification of these rare molecular subtypes is clinically important due to their resistance to imatinib therapy.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"4248128"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10153240","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}
Hannah Saven, Ashton Harmacinski, Andrew Canakis, Uni Wong
{"title":"A Crohn's Disease Patient Found to Have <i>Entamoeba histolytica</i> Infection Causing Pyogenic Liver Abscess.","authors":"Hannah Saven, Ashton Harmacinski, Andrew Canakis, Uni Wong","doi":"10.1155/2023/9936613","DOIUrl":"https://doi.org/10.1155/2023/9936613","url":null,"abstract":"<p><p><i>Entamoeba histolytica</i> is a parasite that typically causes amoebic dysentery but can result in complications such as pyogenic liver abscess. Patients with inflammatory bowel disease often take immunosuppressive therapies that make them more susceptible to such infections. Notably, parasitic infections in this context are rare in nonendemic areas. We describe a 57-year-old man who recently started infliximab therapy for Crohn's disease and presented with fever and right upper quadrant pain. While hospitalized, this patient was diagnosed with <i>Entamoeba histolytica</i> liver abscess. This case demonstrates that parasitic infections should be considered early in immunocompromised patients with inflammatory bowel disease.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"9936613"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9968635","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":"Necrotizing Pancreatitis Infected with <i>Stenotrophomonas maltophilia</i>: An Emerging Rare Multidrug-Resistant Organism.","authors":"Sophia Dar, Nooraldin Merza, Maryam Haider, Yousaf Zafar, Noren Din, Rosario Ligresti, Rani Sebti","doi":"10.1155/2023/8071158","DOIUrl":"https://doi.org/10.1155/2023/8071158","url":null,"abstract":"<p><p><i>Stenotrophomonas maltophilia</i> (SM) is a multidrug-resistant, Gram-negative (GN) bacillus that is an increasingly recognized nosocomial and environment pathogen. It is intrinsically resistant to carbapenems, a drug commonly utilized in the management of necrotizing pancreatitis (NP). We report a 21-year-old immunocompetent female with NP complicated by pancreatic fluid collection (PFC) infected with SM. One-third of patients with NP will develop infections by GN bacteria, while broad-spectrum antibiotics, including carbapenems, cover most infections, trimethoprim-sulfamethoxazole (TMP-SMX) is the first-line treatment antibiotic for SM. This case is critical because it highlights a rare pathogen that should be considered a causal pathogen in patients who do not respond to their care plan.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"8071158"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9801313","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}