Case Reports in Gastrointestinal Medicine最新文献

{"title":"Endoscopic Submucosal Dissection for Resolution of a Symptomatic Pancreatic Rest in a Pediatric Patient: A Case Report and Literature Review.","authors":"Sandra Mabel Camacho-Gomez,&nbsp;Chris Moreau,&nbsp;James Noel,&nbsp;Robert Adam Noel,&nbsp;Sandeep Patel","doi":"10.1155/2021/8853120","DOIUrl":"https://doi.org/10.1155/2021/8853120","url":null,"abstract":"<p><p>The pancreatic rest, aberrant, or heterotopic pancreas is a normal function pancreas found in the submucosal layer of the greater curvature of the gastric antrum and occasionally in the duodenum. Most of the patients are asymptomatic and the finding is usually incidental. We describe the case of a child with abdominal pain and history of recurrent ulcers that necessitated esophagogastroduodenoscopy and further evaluation with endoscopic ultrasound that confirmed a submucosal lesion consistent with a pancreatic rest. Endoscopic submucosal dissection was performed without complication, and complete symptom resolution was achieved after dissection of the pancreatic rest.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2021 ","pages":"8853120"},"PeriodicalIF":0.7,"publicationDate":"2021-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8455212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39443834","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 Unique Case of Mantle Cell Lymphoma Masquerading as a Cecal Mass.","authors":"Sarahi Herrera-Gonzalez,&nbsp;Dema Shamoon,&nbsp;Tingliang Shen,&nbsp;Simon Badin,&nbsp;Yatinder Bains","doi":"10.1155/2021/5581043","DOIUrl":"https://doi.org/10.1155/2021/5581043","url":null,"abstract":"<p><p>Mantle cell lymphoma (MCL), a type of B-cell non-Hodgkin's lymphoma, is a rare and aggressive disease with a poor prognosis due to its advanced presentation at diagnosis. It is characterized by a translocation in the Bcl-1 gene, which results in overexpression of cyclin D1. MCL is frequently seen in the form of multiple lymphomatous polyposis (MLP) in which innumerable polyps are observed in the gastrointestinal (GI) tract. In rare instances, MCL presents a single mass. The most common presentation involves male patients in their sixties, with generalized lymphadenopathy, extranodal involvement, and B symptoms (night sweats, fever, and weight loss). Endoscopic findings of MLP include cerebroid folding of the gastric mucosa and innumerable polyps extending from the duodenum to the large intestine and are reported in approximately 9% of all GI lymphomas. Less commonly, only 2-4% of GI malignancies present as a primary GI MCL as a single mass, usually in the stomach and ileocecal region in the intestine. Radiologic findings include lymphadenopathy, splenomegaly, multiple polyposis, or wall thickening with ulceration or mass formation. In most instances, advanced disease is found at diagnosis, for which 5-year survival ranges only from 26 to 46%, even when appropriate treatment is initiated. High mitotic rate, or Ki-67 index, is of prognostic value and is associated with poor prognosis. Treatment involves conventional chemo-immunotherapy consisting of R CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) or RB (rituximab and bendamustine), with the latter being better tolerated and associated with longer progression-free survival. Surgical resection is usually limited to patients in which complications are seen such as bleeding, perforation, or bowel obstruction. We present a unique case of a 70-year-old male with nonbilious, nonbloody emesis, and symptomatic anemia who was found to have a cecal mass consistent with MCL.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2021 ","pages":"5581043"},"PeriodicalIF":0.7,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8449714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39434600","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":"The Effect of the Platelet Administration for the Patients with Liver Dysfunction after Liver Resection: Preliminary Clinical Trial.","authors":"Hui Xu,&nbsp;Yu-Mei Li,&nbsp;Yongxiang Yi,&nbsp;Yun-Wen Zheng,&nbsp;Nobuhiro Ohkohchi","doi":"10.1155/2021/9948854","DOIUrl":"https://doi.org/10.1155/2021/9948854","url":null,"abstract":"<p><p>The aim of this study is to investigate the effect of platelet on the improvement of deteriorated liver function after liver resection. Six patients with hepatocellular carcinoma and liver cirrhosis have received the partial hepatectomy in the institution. Their Child-Pugh grade was B, and platelet count was below 7,000/<i>µ</i>l. After hepatectomy, 20 units of platelet transfusion were carried out, liver function and side effects were investigated after 4 weeks, and the number of platelets increased to approximately 15,000/<i>µ</i>l. Liver functions, such as aspartate transaminase (AST), alanine aminotransferase (ALT), cholinesterase (ChE), and prothrombin time, as well as albumin, recover to the same level as those before operation and 4 weeks after the operation. Any side effects were not recognized in all patients. Administration of platelets for cirrhotic patient with hepatectomy was carried with safety. But remarkable effect on the improvement of liver function was not recognized.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2021 ","pages":"9948854"},"PeriodicalIF":0.7,"publicationDate":"2021-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8448609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39432934","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":"An Exceedingly Rare Case of Liraglutide-Induced Liver Injury.","authors":"Swetha Parvataneni,&nbsp;Rajarajeshwari Ramachandran,&nbsp;Eric Then,&nbsp;Tyler Grantham,&nbsp;Vinaya Gaduputi","doi":"10.1155/2021/6306149","DOIUrl":"https://doi.org/10.1155/2021/6306149","url":null,"abstract":"<p><p>Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist used for the treatment of type 2 diabetes mellitus. We are reporting the second case of liraglutide-induced liver injury, with complete resolution of liver injury after discontinuation of the drug.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2021 ","pages":"6306149"},"PeriodicalIF":0.7,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8405313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39375546","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":"Late-Onset Posttransplant Lymphoproliferative Disorder Results in Jejunal Stricture Managed with Endoscopic Dilation.","authors":"Steven Park,&nbsp;John Miller,&nbsp;Janice Cheong,&nbsp;Asad Ullah,&nbsp;Lawrence Saubermann,&nbsp;Arthur Decross","doi":"10.1155/2021/5583665","DOIUrl":"https://doi.org/10.1155/2021/5583665","url":null,"abstract":"<p><strong>Background: </strong>Late-onset posttransplant lymphoproliferative disorder (PTLD) after orthotopic heart transplantation is rare. <i>Case Presentation</i>. We present a rare diagnosis of small bowel stricture caused by healed lymphomatous ulcers in a patient with orthotopic heart transplantation and PTLD diagnosed 25 years after initial transplantation. We also demonstrate successful endoscopic balloon dilations that improved the patient's obstructive symptoms.</p><p><strong>Conclusion: </strong>It is important to consider stricture from healed lymphomatous ulcers in posttransplant patients presenting with obstructive symptoms.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2021 ","pages":"5583665"},"PeriodicalIF":0.7,"publicationDate":"2021-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8357503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39313393","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":"Serious Complications of EUS-Guided Hepaticoesophagostomy due to Transmural Stent Migration.","authors":"Mateusz Jagielski,&nbsp;Michał Zieliński,&nbsp;Jacek Piątkowski,&nbsp;Marek Jackowski","doi":"10.1155/2021/4639286","DOIUrl":"https://doi.org/10.1155/2021/4639286","url":null,"abstract":"<p><p>Thoracic complications, such as biliopleural fistula and bile leaking into the right pleural cavity, are serious adverse events of transmural endoscopic ultrasound- (EUS-) guided biliary drainage involving EUS-guided hepaticoesophagostomy (EUS-HES). In this article, the authors present endoscopic treatment of biliopleural fistula as a serious thoracic complication of EUS-HES. The authors highlight key components of EUS-guided transmural biliary drainage and their experience with particular emphasis on endoscopic treatment of thoracic complications.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2021 ","pages":"4639286"},"PeriodicalIF":0.7,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39312844","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":"Neurologic Imaging in a Patient with Cirrhosis and Altered Mental Status: To CT or Not to CT.","authors":"Alexander Polyak,&nbsp;Serguei Bannykh,&nbsp;Andrew Klein,&nbsp;Vinay Sundaram","doi":"10.1155/2021/5588208","DOIUrl":"https://doi.org/10.1155/2021/5588208","url":null,"abstract":"<p><p>Hepatic encephalopathy represents a continuum of neuropsychiatric symptoms among patients with end-stage liver disease. When a patient with cirrhosis presents with altered mental status (AMS), routine neurologic imaging is not typically recommended, due to low diagnostic yield. Guidance from the American Association for the Study of Liver Disease states that, on initial presentation, brain imaging is not required unless there are other signs of intracranial pathology, including focal neurologic deficits. We present a case of a 61-year-old female with cirrhosis presenting with AMS without focal deficits, in whom neurological imaging revealed a meningioma and subsequent resection led to symptom improvement.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2021 ","pages":"5588208"},"PeriodicalIF":0.7,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8349247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39296409","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 Spontaneous Bacterial Empyema in Cirrhotic Patient.","authors":"Erica Chow,&nbsp;Bashar Khiatah,&nbsp;Amanda Frugoli","doi":"10.1155/2021/6685998","DOIUrl":"https://doi.org/10.1155/2021/6685998","url":null,"abstract":"<p><p>Spontaneous bacterial empyema (SBEM), also called spontaneous bacterial pleuritis, is an infection of the pleural space that arises in the setting of cirrhosis and, by definition, the absence of pneumonia. It is likely underdiagnosed as its symptoms are nonspecific and it lacks standardized diagnostic and therapeutic recommendations. SBEM represents a distinct complication of hepatic hydrothorax with different pathogenesis, presentation, and treatment strategy from those of empyema secondary to pneumonia. Surprisingly, nearly 40% of episodes of spontaneous empyema are not associated with spontaneous bacterial peritonitis. Although SBEM is amenable to prompt antibiotic therapy, it has a high rate of mortality and morbidity. A high clinical suspicion is crucial for patient survival and timely initiation of appropriate antibiotics. Increased understanding, recognition, and standardization of treatment would help alleviate the relatively high burden of SBEM. In this case vignette, we provide a review of the relevant literature, and we describe a rare case of SBEM in a patient with a history of alcohol-associated liver cirrhosis and prior episode of spontaneous bacterial peritonitis (SBP). SBEM was diagnosed with thoracentesis and analysis of the aspirate, and he was treated with ceftriaxone with resolution of his presenting abdominal pain and leukocytosis.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2021 ","pages":"6685998"},"PeriodicalIF":0.7,"publicationDate":"2021-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39265843","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":"Intraoperative Endoscopy in Transient Adult Jejunojejunal Intussusception.","authors":"Takeshi Okamoto,&nbsp;Hidekazu Suzuki,&nbsp;Katsuyuki Fukuda","doi":"10.1155/2021/3718089","DOIUrl":"https://doi.org/10.1155/2021/3718089","url":null,"abstract":"<p><p>Despite improvements in imaging modalities, causative lead points in adult intussusception may be difficult to diagnose. Such lead points can be malignant, causing recurrence or metastases if left unresected. We describe a case of transient adult jejunojejunal intussusception, in which intraoperative endoscopy was used to confirm the absence of a lead point. A 39-year-old woman with a history of laparoscopic oophorectomy presented with epigastric pain, nausea, and vomiting. Contrast computed tomography revealed jejunojejunal intussusception, with no visible lead point. Spontaneous reduction was confirmed during exploratory laparoscopy. After lysis of adhesions, intraoperative peroral jejunoscopy was performed with the surgeons' assistance. Endoscopy confirmed the absence of tumor, and bowel resection was avoided. No recurrence has been observed during 24 months of follow-up. Intraoperative endoscopy may provide additional reassurance for the absence of a lead point in cases where preoperative enteroscopy cannot be performed and no lead points can be identified on imaging.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2021 ","pages":"3718089"},"PeriodicalIF":0.7,"publicationDate":"2021-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39265883","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":"Hepatic Squamous Cell Carcinoma Diagnosed by Endoscopic Ultrasound-Guided Fine-Needle Aspiration.","authors":"Koki Yamada,&nbsp;Susumu Shinoura,&nbsp;Kaoru Kikuchi","doi":"10.1155/2021/9939898","DOIUrl":"https://doi.org/10.1155/2021/9939898","url":null,"abstract":"<p><p>Primary hepatic squamous cell carcinoma (SCC) is a rare malignancy with aggressive clinical features. This is the first case report of a primary hepatic SCC diagnosed by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), which is a reliable and safe procedure for the histopathological diagnosis of liver lesions, even if the percutaneous approach is difficult due to ascites or hypervascularity at the puncture site. A 52-year-old man presented to the emergency department of a tertiary referral hospital with right upper quadrant abdominal pain and abdominal distention. Given the laboratory data, a diagnosis of spontaneous bacterial peritonitis (SBP) was made. Concurrently, an abdominal computed tomography (CT) scan revealed an 8 cm hypodense mass with delayed peripheral enhancement in the left hepatic lobe and paraaortic and perihepatic lymphadenopathy. As persistent ascites precluded percutaneous liver biopsy, we performed EUS-FNA of the liver mass, and the obtained specimen showed SCC. As otorhinolaryngological consultation and whole-body investigations, including chest CT, upper and lower endoscopy, and positron emission tomography CT, were all unremarkable except for the liver lesion and lymph nodes, a diagnosis of primary hepatic SCC with systemic lymph node metastasis was made. After treatment of SBP with antibiotics, we initiated chemotherapy concurrent with radiation therapy, adapted to his liver function. Radiation and three cycles of chemotherapy were not effective as the disease progressed, as seen on the follow-up CT scan, and the patient died of hepatic failure on the 134th day after diagnosis. In conclusion, EUS-FNA was a reliable method for tissue sampling in liver malignancies, particularly in selected patients with contraindications for percutaneous biopsy.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2021 ","pages":"9939898"},"PeriodicalIF":0.7,"publicationDate":"2021-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8277514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39258524","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}