Mohammed Rifat Shaik, Chet Ranabhat, Nishat Anjum Shaik, Akshay Duddu, Zaid Bilgrami, Guofeng Xie
{"title":"Gastric Pneumatosis in the Setting of Diabetic Ketoacidosis.","authors":"Mohammed Rifat Shaik, Chet Ranabhat, Nishat Anjum Shaik, Akshay Duddu, Zaid Bilgrami, Guofeng Xie","doi":"10.1155/2023/6655536","DOIUrl":"https://doi.org/10.1155/2023/6655536","url":null,"abstract":"<p><p>Gastric pneumatosis, an uncommon radiologic finding characterized by the presence of gas within the gastric wall, presents a diagnostic challenge due to its association with both benign gastric emphysema and more severe emphysematous gastritis. The contrasting outcomes and management approaches for these conditions underscore the necessity for accurate diagnosis and appropriate intervention. We present a case of a 29-year-old female with a medical history significant for type 1 diabetes mellitus who presented with abdominal pain, nausea, and vomiting. Initial evaluation revealed elevated blood glucose levels, an anion gap metabolic acidosis, and evidence of gastric pneumatosis on imaging. The patient was managed with aggressive fluid resuscitation and intravenous insulin therapy per diabetic ketoacidosis protocol. General surgery evaluation ruled out the need for acute surgical intervention and attributed the gastric pneumatosis to increased intragastric pressures from prolonged vomiting. The patient was managed with conservative measures, including nasogastric tube decompression and antibiotics. Over the course of a few days, the patient showed signs of clinical and radiologic improvement, with a resolution of symptoms. This case highlights the importance of accurate diagnosis and appropriate management strategies tailored to the underlying pathology to optimize patient outcomes in cases of gastric pneumatosis.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"6655536"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10220862","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":"Ectopic Cecal Varices as a Cause of Lower Gastrointestinal Bleeding.","authors":"Abdulrahman Qatomah, Sulaiman Almushir, Faisal Aljohani","doi":"10.1155/2023/7005565","DOIUrl":"https://doi.org/10.1155/2023/7005565","url":null,"abstract":"<p><p>Ectopic varices account for 1%-5% of all variceal bleeding episodes in patients with portal hypertension. They can be found at any part of gastrointestinal tract including the small intestines, colon, or rectum. We report a case of a 59-year-old man who presented with bleeding per rectum 2 days after a routine colonoscopy, in which 2 lesions were biopsied. Gastroscopy was negative for bleeding, and he was not stable enough to undergo colonoscopy. CT angiography showed a large portosystemic shunt with multiple collaterals in the right lower quadrant. These findings were clues for a diagnosis of ectopic cecal varices.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"7005565"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10287515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9770468","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}
Sucong Lyu, Guoqiang Zhong, Hui Chen, Jin Li, Mingsong Li
{"title":"The First Case of Cribriform-Morular Thyroid Carcinoma and FAP with APC Gene Mutation in China: A Case Report and Brief Review.","authors":"Sucong Lyu, Guoqiang Zhong, Hui Chen, Jin Li, Mingsong Li","doi":"10.1155/2023/6222432","DOIUrl":"https://doi.org/10.1155/2023/6222432","url":null,"abstract":"<p><p>The cribriform-morular variant of papillary thyroid carcinoma (CMV-PTC) is now designated as morular cribriform thyroid carcinoma (CMTC) according to the 5<sup>th</sup> edition of the World Health Organization (WHO) Classification of Thyroid Tumors. CMTC can appear within a familial adenomatous polyposis (FAP) or be sporadic. We report the first case of a young female patient in China who was diagnosed with FAP and CMTC with a mutation in exon 16 of the APC gene underlying the disease. The main purpose of this case report is to provide a special pathological type of thyroid tumors, which is expected to be helpful for clinical work in the future.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"6222432"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10212671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9917531","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}
Kevin Yang, Nariman Hossein-Javaheri, Naren Nallapeta, Mayada Ismail
{"title":"Perigastric Hematoma Masquerading as a Gastric Tumor.","authors":"Kevin Yang, Nariman Hossein-Javaheri, Naren Nallapeta, Mayada Ismail","doi":"10.1155/2023/9568983","DOIUrl":"https://doi.org/10.1155/2023/9568983","url":null,"abstract":"<p><p>Perigastric and intramural gastric hematomas rarely occur, with most cases associated with trauma, coagulopathy, and peptic ulcer disease. Furthermore, hematomas in the upper gastrointestinal tract are commonly located in the esophagus and duodenum. In this case report, we describe a hematoma masquerading as a gastric tumor on esophagogastroduodenoscopy (EGD) in a 54-year-old male presenting with melena. Initial computed tomography (CT) imaging suggested gastrointestinal stromal tumor (GIST) as the probable cause. We performed endoscopic ultrasound (EUS) with findings consistent with a perigastric hematoma, which aligned with the patient's diagnosis of splenic vein thrombosis (SVT) and numerous collateral vessels communicating with the hematoma. Interventional radiology (IR) was consulted for further management, although we ultimately chose a conservative approach.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"9568983"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10462448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10120537","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":"New-Onset Crohn's Disease following Initiation of Secukinumab: A Case Report and Review of the Role of IL-17 in the Pathogenesis of Crohn's Disease.","authors":"Anas Khouri, Cesar Moreno, Benjamin Niland","doi":"10.1155/2023/1769290","DOIUrl":"https://doi.org/10.1155/2023/1769290","url":null,"abstract":"<p><p>Patients with autoimmune conditions show a high expression of proinflammatory cytokines including interleukin (IL)-17. While IL-17 inhibitors have demonstrated efficacy in managing autoimmune disorders, rare instances of de novo or exacerbated inflammatory bowel disease (IBD) have been reported. The factors that affect the onset and severity remain unclear. Here, we present a case of a 38-year-old female who developed manifestations of Crohn's disease within 1 month of initiating secukinumab treatment for psoriatic arthritis, in addition to a review of the role of IL-17 in the pathophysiology of Crohn's disease.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"1769290"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9565438","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}
Seo Hyun Kim, Youssef Soliman, Vikas N Chitnavis, Maithili V Chitnavis
{"title":"<i>Helicobacter Pylori</i>-Negative MALT Lymphoma: A Series of Two Cases Presenting with Life-Threatening Upper Gastrointestinal Bleeding.","authors":"Seo Hyun Kim, Youssef Soliman, Vikas N Chitnavis, Maithili V Chitnavis","doi":"10.1155/2023/8244696","DOIUrl":"https://doi.org/10.1155/2023/8244696","url":null,"abstract":"<p><p>Mucosa-associated lymphoid tissue (MALT) lymphoma is a common cause of gastric lymphoma. Although most cases are associated with an <i>H. pylori</i> infection, approximately 10% are <i>H. pylori</i>-negative. Patients with gastric MALT lymphoma are usually asymptomatic or present with nonspecific symptoms such as abdominal pain, dyspepsia, weight loss, and occult gastrointestinal bleeding. In this report, we describe two patients with <i>H. pylori</i>-negative MALT lymphoma who both presented with acute upper gastrointestinal bleeding that led to hemodynamic instability. After resuscitation, emergent endoscopy was performed. Both patients had the <i>t</i> (11; 18) (q21; q21) translocation, which prompted direct treatment by radiotherapy.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"8244696"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10063354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9242154","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}
Mark G Evans, Jack P Guccione, Anthony Crymes, Xiaodong Li, Cary A Johnson, Vishal S Chandan, Yuxin Lu
{"title":"Atypical Presentations of Collagenous Gastritis Mimicking Celiac Sprue.","authors":"Mark G Evans, Jack P Guccione, Anthony Crymes, Xiaodong Li, Cary A Johnson, Vishal S Chandan, Yuxin Lu","doi":"10.1155/2023/4073588","DOIUrl":"https://doi.org/10.1155/2023/4073588","url":null,"abstract":"<p><p>Collagenous gastritis has been reported as a rare cause of nausea, diarrhea, weight changes, and early satiety in female patients. Here, we describe two women aged 43 and 71 years who presented with similar symptoms. Gastric biopsies from both individuals showed thickened, irregular subepithelial collagen bands (>10 <i>μ</i>m). The pathogenesis of collagenous gastritis is poorly understood, but it may be the presenting symptom for many underlying autoimmune conditions. In particular, there is a well-established connection between collagenous disorders of the gastrointestinal tract and celiac sprue, Sjögren syndrome, and lymphocytic colitis; however, none of these conditions had been diagnosed in our patients. The older woman had incidentally discovered hypogammaglobinemia and IgA deficiency, whereas the younger woman suffered from fibromyalgia. Although a gluten-free diet and budesonide have been effective in some cases, there is no standardized therapy for collagenous gastritis. Our patients trialed diet modification and have required no additional medical interventions.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"4073588"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9940950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10765170","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":"Acquiring the Diagnosis of an Acquired Tracheoesophageal Fistula with EtCO<sub>2</sub>: A Case Discussion with Review of the Literature.","authors":"Janine Beatrice Borja, Ghanshyam Patel, Luqman Baloch, Ammar Aqeel, Mool Chand, Hariprasad Korsapati, Altaf Dawood, Naser Khan","doi":"10.1155/2023/9437558","DOIUrl":"https://doi.org/10.1155/2023/9437558","url":null,"abstract":"<p><p>Acquired tracheoesophageal fistula (TEF) is a rare complication of esophageal or lung cancer. A 57-year-old male presented with complaints of vomiting, cough, 20 lb weight loss, and progressive dysphagia. Early laryngoscopy and CT chest showed a normal pharynx with an irregular thickness of the thoracic esophagus. The upper gastrointestinal endoscopy (UGIE) and upper endoscopic ultrasound (EUS) revealed a hypoechoic mass evolving as complete obstruction. During the procedure, minimal CO<sub>2</sub> was used for insufflation; however, when attempts were made to traverse the obstruction, capnography revealed an end-tidal CO<sub>2</sub> (EtCO<sub>2</sub>) estimating 90 mmHg indicating possible TEF. This case depicts the use of capnography during UGIE in diagnosing an acquired TEF.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"9437558"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10042631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9213288","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 Image 2 Hours after PuraStat® Application: A Case of Achieving Hemostasis Using PuraStat® for Postgastric Lesion Biopsy Bleeding after Hemostatic Clips Failed.","authors":"Yoshitsugu Misumi, Kouichi Nonaka, Maiko Kishino","doi":"10.1155/2023/5620348","DOIUrl":"https://doi.org/10.1155/2023/5620348","url":null,"abstract":"<p><p>PuraStat® (3D Matrix, Tokyo, Japan) is a novel, self-assembling peptide hemostatic hydrogel that can be used endoscopically. Hemostasis can be physically obtained by covering bleeding points; however, there are no reports of how long PuraStat remains in the upper gastrointestinal tract. Herein, we report a case wherein esophagogastroduodenoscopy (EGD) was performed 2 hours after PuraStat application. A 73-year-old man underwent EGD for evaluation of lesions in the posterior wall of the stomach. A biopsy was then performed on the gastric lesions; however, massive bleeding occurred. A hemostatic clip was used to stop bleeding but failed; primary hemostasis was obtained by applying PuraStat. EGD performed 2 hours later to determine whether the patient could be discharged revealed that the white-turning PuraStat gel remained firmly in the applied area, confirming complete hemostasis. PuraStat is a hemostatic agent capable of physical hemostasis that reliably remains in the stomach even after a few hours of use and, thus, may replace some conventional hemostasis methods.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"5620348"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10397489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9955823","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}
Aida Nasirishargh, Bao Sean Huy Nguyen, Michael J Lawson, Eric J Mao
{"title":"A Case of Esophago-Respiratory Fistula due to Inhalation Smoke Injury Diagnosed by Upper Endoscopy.","authors":"Aida Nasirishargh, Bao Sean Huy Nguyen, Michael J Lawson, Eric J Mao","doi":"10.1155/2023/4231287","DOIUrl":"https://doi.org/10.1155/2023/4231287","url":null,"abstract":"<p><p>Esophago-respiratory fistula (ERF) refers to the formation of a pathological connection between the esophagus and respiratory tract. Acquired ERF is a rare but life-threatening diagnosis in adults. We describe a 79-year-old male who was admitted with an inhalation smoke injury. He was diagnosed with ERF by endoscopic visualization and sampling of the hyaline cartilage within the wall of the esophagus. Percutaneous endoscopic gastrostomy placement and conservative measures were effective in the management of ERF.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2023 ","pages":"4231287"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9842409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10604632","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}