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Innovative Endoscopic Management of Recurrent Gastrogastric Fistula Post-Roux-en-Y Gastric Bypass Patient Using Cardiac Septal Occluder and Lumen-Apposing Metal Stent. 使用心脏隔膜封堵器和腔内金属支架对鲁氏-Y 胃旁路术后复发性胃胃瘘进行创新性内窥镜治疗
IF 0.6
ACG Case Reports Journal Pub Date : 2025-03-17 eCollection Date: 2025-03-01 DOI: 10.14309/crj.0000000000001642
Ajay Gade, Kalpit Devani
{"title":"Innovative Endoscopic Management of Recurrent Gastrogastric Fistula Post-Roux-en-Y Gastric Bypass Patient Using Cardiac Septal Occluder and Lumen-Apposing Metal Stent.","authors":"Ajay Gade, Kalpit Devani","doi":"10.14309/crj.0000000000001642","DOIUrl":"10.14309/crj.0000000000001642","url":null,"abstract":"<p><p>Gastrogastric fistula (GGF) is a rare complication of post-Roux-en-Y gastric bypass, often challenging to manage. This case report presents a 63-year-old patient with recurrent GGF and gastrojejunal stricture, refractory to prior endoscopic treatments. Using a minimally invasive approach with atrial septal defect closure device and a lumen-apposing metal stent, the fistula was successfully closed, and stricture relieved. The patient reported complete symptom resolution at follow-up. This innovative approach of combining a cardiac septal occluder and lumen-apposing metal stent for management of complex GGF cases offers a promising alternative to surgical interventions.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 3","pages":"e01642"},"PeriodicalIF":0.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646785","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}
引用次数: 0
A Novel Application of a Through the Scope Fully Covered Esophageal Stent for an Endoscopic Ultrasound-Directed Transgastric Endoscopic Retrograde Cholangiopancreatography Procedure. 超声内镜下经胃内镜逆行胰胆管造影中经镜全覆盖食管支架的新应用。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-03-14 eCollection Date: 2025-03-01 DOI: 10.14309/crj.0000000000001648
Kareena S Garg, Saad A Haque
{"title":"A Novel Application of a Through the Scope Fully Covered Esophageal Stent for an Endoscopic Ultrasound-Directed Transgastric Endoscopic Retrograde Cholangiopancreatography Procedure.","authors":"Kareena S Garg, Saad A Haque","doi":"10.14309/crj.0000000000001648","DOIUrl":"https://doi.org/10.14309/crj.0000000000001648","url":null,"abstract":"<p><p>Performing traditional endoscopic retrograde cholangiopancreatography (ERCP) in patients with Roux-en-Y gastric bypass anatomy is challenging. The endoscopic ultrasound-directed transgastric ERCP (EDGE) procedure offers a minimally invasive solution. This case describes a 53-year-old woman with a history of Roux-en-Y gastric bypass presenting with cholelithiasis, abnormal liver function tests, and cholecystitis. After initial conservative treatment, a staged EDGE procedure was performed. A lumen-apposing metal stent (LAMS) was placed in the jejunum, but subsequent attempts to cannulate it with the ERCP scope were unsuccessful due to \"bowing\" of the efferent loop. A fully covered esophageal stent was placed through the LAMS creating a \"ramp\" allowing passage of the duodenoscope, enabling successful ERCP and stone removal. This case highlights an effective technique to overcome often encountered challenges accessing LAMS during an EDGE procedure.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 3","pages":"e01648"},"PeriodicalIF":0.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646713","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}
引用次数: 0
Foveolar Gland Metaplasia of the Duodenal Bulb on Retrograde View of the Pylorus. 幽门逆行观察十二指肠球部小窝腺化生。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-03-13 eCollection Date: 2025-03-01 DOI: 10.14309/crj.0000000000001645
Zaid Ansari, Pablo Bejarano, Asad Rahman
{"title":"Foveolar Gland Metaplasia of the Duodenal Bulb on Retrograde View of the Pylorus.","authors":"Zaid Ansari, Pablo Bejarano, Asad Rahman","doi":"10.14309/crj.0000000000001645","DOIUrl":"10.14309/crj.0000000000001645","url":null,"abstract":"","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 3","pages":"e01645"},"PeriodicalIF":0.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623110","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}
引用次数: 0
Rare Presentation of Eosinophilic Cholangitis in a 32-Year-Old Man. 32岁男性嗜酸性胆管炎的罕见表现。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-03-13 eCollection Date: 2025-03-01 DOI: 10.14309/crj.0000000000001641
Himsikhar Khataniar, Hany Habib, Molly Ruiz, Ashni Dharia, Sheena Magoo, Abhijit Kulkarni
{"title":"Rare Presentation of Eosinophilic Cholangitis in a 32-Year-Old Man.","authors":"Himsikhar Khataniar, Hany Habib, Molly Ruiz, Ashni Dharia, Sheena Magoo, Abhijit Kulkarni","doi":"10.14309/crj.0000000000001641","DOIUrl":"10.14309/crj.0000000000001641","url":null,"abstract":"<p><p>Eosinophilic cholangitis (EC) is a rare condition characterized by eosinophilic infiltration of the bile ducts, often mimicking diseases like primary sclerosing cholangitis or cholangiocarcinoma. We report the case of a 32-year-old man with severe epigastric pain and elevated liver function tests. Initial imaging revealed common bile duct dilation and multiple strictures, initially suggestive of primary sclerosing cholangitis. Multiple endoscopic retrograde cholangiopancreatographies with brushings showed benign cytology but revealed polysomy on fluorescence in situ hybridization. A biopsy confirmed EC. High-dose corticosteroids led to significant clinical improvement. This case underscores the importance of considering EC in the differential diagnosis of biliary diseases, as timely diagnosis and treatment can lead to excellent outcomes.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 3","pages":"e01641"},"PeriodicalIF":0.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623192","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}
引用次数: 0
Esophageal Siderosis: An Unusual Complication of Oral Iron Therapy. 食道铁沉着：口服铁治疗的一种罕见并发症。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.14309/crj.0000000000001644
Gianna Stoleru, Meera Jain, Anna Vi Jones, Alexander Podboy
{"title":"Esophageal Siderosis: An Unusual Complication of Oral Iron Therapy.","authors":"Gianna Stoleru, Meera Jain, Anna Vi Jones, Alexander Podboy","doi":"10.14309/crj.0000000000001644","DOIUrl":"10.14309/crj.0000000000001644","url":null,"abstract":"<p><p>Iron is the most common nutritional deficiency encountered in the United States, with over 15% of Americans using some form of daily oral iron supplementation. Although commonly associated with minor gastrointestinal side effects, severe gastrointestinal complications are rare. Direct cytotoxic mucosal damage and subsequent ulcer formation have rarely been reported. Among reported cases, most are found in the stomach with extragastric manifestations of siderosis being less commonly described. We report a rare case of esophageal siderosis related to oral iron supplementation.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 3","pages":"e01644"},"PeriodicalIF":0.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613032","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}
引用次数: 0
Endoscopic Vacuum Therapy for the Treatment of Atrial Fibrillation Ablation-Induced Esophageal Perforation. 内镜下真空疗法治疗心房颤动消融所致食道穿孔。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.14309/crj.0000000000001650
Larissa Lushniak, Neal Dharmadhikari, Kaveh Zivari, Juan Pablo Reyes Genere, Vladimir Kushnir, Ahmad Najdat Bazarbashi
{"title":"Endoscopic Vacuum Therapy for the Treatment of Atrial Fibrillation Ablation-Induced Esophageal Perforation.","authors":"Larissa Lushniak, Neal Dharmadhikari, Kaveh Zivari, Juan Pablo Reyes Genere, Vladimir Kushnir, Ahmad Najdat Bazarbashi","doi":"10.14309/crj.0000000000001650","DOIUrl":"10.14309/crj.0000000000001650","url":null,"abstract":"<p><p>Esophageal thermal injury from atrial fibrillation ablation is not uncommon; however, full-thickness perforation is rare. Such injuries are often treated with surgical revision, stent placement, or medical management. Endoscopic vacuum therapy is a novel and emerging technique to repair transmural gastrointestinal defects; however, its use in the management of esophageal thermal ulceration and perforation after a cardiac ablation procedure is limited. We present a 52-year-old man who developed a refractory esophageal perforation and leak secondary to atrial fibrillation radiofrequency ablation that was successfully treated with endoscopic vacuum therapy, demonstrating a minimally invasive endoscopic treatment modality when alternative therapies fail.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 3","pages":"e01650"},"PeriodicalIF":0.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613026","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}
引用次数: 0
Acute Kidney Injury Secondary to Fecaloma: A Rare Complication of Chronic Constipation. 继发于粪瘤的急性肾损伤：一种罕见的慢性便秘并发症。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.14309/crj.0000000000001646
Erik Almazan, Elizabeth M Petersen
{"title":"Acute Kidney Injury Secondary to Fecaloma: A Rare Complication of Chronic Constipation.","authors":"Erik Almazan, Elizabeth M Petersen","doi":"10.14309/crj.0000000000001646","DOIUrl":"https://doi.org/10.14309/crj.0000000000001646","url":null,"abstract":"","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 3","pages":"e01646"},"PeriodicalIF":0.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612987","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}
引用次数: 0
Early-Onset Colorectal Cancer: When to Include Cowden Syndrome in Your Differential Diagnosis. 早发性结直肠癌：何时将考登综合征纳入鉴别诊断。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.14309/crj.0000000000001643
Joshua Morny, Anna Zakas, Samuel Koebe, Jennifer M Weiss
{"title":"Early-Onset Colorectal Cancer: When to Include Cowden Syndrome in Your Differential Diagnosis.","authors":"Joshua Morny, Anna Zakas, Samuel Koebe, Jennifer M Weiss","doi":"10.14309/crj.0000000000001643","DOIUrl":"10.14309/crj.0000000000001643","url":null,"abstract":"","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 3","pages":"e01643"},"PeriodicalIF":0.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613000","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}
引用次数: 0
Tissue Remodeling for a More Homogenous Ablation in Transoral Outlet Reduction Using Suturing and Noncontact Argon Plasma Coagulation. 利用缝合和非接触式氩等离子体凝固技术进行组织重塑，使经口缩口术中的消融更加均匀。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-03-06 eCollection Date: 2025-03-01 DOI: 10.14309/crj.0000000000001631
Leandro Sierra, Arjun Chatterjee, Akash Khurana, Renan Prado, Roma Patel, Stephen A Firkins, Roberto Simons-Linares
{"title":"Tissue Remodeling for a More Homogenous Ablation in Transoral Outlet Reduction Using Suturing and Noncontact Argon Plasma Coagulation.","authors":"Leandro Sierra, Arjun Chatterjee, Akash Khurana, Renan Prado, Roma Patel, Stephen A Firkins, Roberto Simons-Linares","doi":"10.14309/crj.0000000000001631","DOIUrl":"10.14309/crj.0000000000001631","url":null,"abstract":"<p><p>The study is the first to assess the argon-plasma coagulation ArC Smart linear beam for mucosal ablation in transoral outlet reduction for weight regain after Roux-en-Y gastric bypass. The noncontact design of the linear beam can enhance tissue healing and remodeling of gastrojejunal anastomosis by causing a uniform scarring with minimal tissue injury. We followed patients for 45 days, during which none experienced gastrointestinal bleeding, stenosis, or ulcers, reporting 9.8% average of total body weight loss. The ArC Smart beam may offer a safer, more effective alternative to traditional argon-plasma coagulation for transoral outlet reduction, with better reduction in weight loss, although comparative studies are needed.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 3","pages":"e01631"},"PeriodicalIF":0.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571661","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}
引用次数: 0
Nonobstructive Recurrent Cholangitis After Hepatobiliary Tract Diversion in Patients With Surgically Altered Anatomy: A Challenging Problem. 手术改变解剖结构的患者肝胆道改道后非梗阻性复发胆管炎：一个具有挑战性的问题。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-03-05 eCollection Date: 2025-03-01 DOI: 10.14309/crj.0000000000001639
Rahul Karna
{"title":"Nonobstructive Recurrent Cholangitis After Hepatobiliary Tract Diversion in Patients With Surgically Altered Anatomy: A Challenging Problem.","authors":"Rahul Karna","doi":"10.14309/crj.0000000000001639","DOIUrl":"10.14309/crj.0000000000001639","url":null,"abstract":"","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 3","pages":"e01639"},"PeriodicalIF":0.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565620","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}
引用次数: 0
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