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Bleeding Colostomy Varices in a Cirrhotic Patient: Successful Management With Glue-Assisted Antegrade and Retrograde Transvenous Obliteration (GAARTO). 肝硬化患者出血性结肠造口静脉曲张：用胶辅助的顺、逆行经静脉闭塞术（GAARTO）成功治疗。
IF 0.5
ACG Case Reports Journal Pub Date : 2025-10-01 DOI: 10.14309/crj.0000000000001850
Ayush Jasrotia, Harshini Revanuru, Pabitra Sahu, Vignesh Kandasamy, Premashis Kar, Sanchit Singh, Jata Shankar Kumar, Subhasish Mazumder, Ashish Garg
{"title":"Bleeding Colostomy Varices in a Cirrhotic Patient: Successful Management With Glue-Assisted Antegrade and Retrograde Transvenous Obliteration (GAARTO).","authors":"Ayush Jasrotia, Harshini Revanuru, Pabitra Sahu, Vignesh Kandasamy, Premashis Kar, Sanchit Singh, Jata Shankar Kumar, Subhasish Mazumder, Ashish Garg","doi":"10.14309/crj.0000000000001850","DOIUrl":"10.14309/crj.0000000000001850","url":null,"abstract":"<p><p>Parastomal varices are rare but potentially life-threatening complication of portal hypertension, often presenting with bleeding at stoma sites and frequently underrecognized due to their ectopic location. We report a 76-year-old man with decompensated cirrhosis and metastatic colon cancer who presented with recurrent colostomy site bleeding 14 years after left hemicolectomy. Computed tomography angiography revealed large portosystemic collaterals consistent with parastomal varices. Owing to high risk associated with transjugular intrahepatic portosystemic shunt, he was treated with glue-assisted antegrade and retrograde transvenous obliteration via inferior mesenteric vein access. The procedure achieved effective hemostasis without complications or recurrence. This case highlights the diagnostic value of computed tomography angiography and the therapeutic potential of glue-assisted antegrade and retrograde transvenous obliteration as a less encephalopathy-prone alternative to transjugular intrahepatic portosystemic shunt in high-risk patients.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 10","pages":"e01850"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211380","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
Gallstone Obstruction in Roux-en-Y Hepaticojejunostomy: An Unusual Challenge After Liver Transplant for Biliary Atresia. Roux-en-Y肝空肠吻合术中胆石性梗阻：胆道闭锁肝移植术后的一个不寻常的挑战。
IF 0.5
ACG Case Reports Journal Pub Date : 2025-10-01 DOI: 10.14309/crj.0000000000001846
Sydney R Donohue, Apoorva K Chandar, Kai Zhao, Anthony B Post
{"title":"Gallstone Obstruction in Roux-en-Y Hepaticojejunostomy: An Unusual Challenge After Liver Transplant for Biliary Atresia.","authors":"Sydney R Donohue, Apoorva K Chandar, Kai Zhao, Anthony B Post","doi":"10.14309/crj.0000000000001846","DOIUrl":"10.14309/crj.0000000000001846","url":null,"abstract":"<p><p>Gallstone obstruction of the hepaticojejunostomy following Kasai hepatoportoenterostomy for congenital biliary atresia is extremely uncommon. More common complications of the Kasai procedure include bile duct strictures, fibrosis, portal hypertension, and cholangitis, which is likely due to reduced lymphatic drainage, intestinal bacterial translocation, and poor biliary drainage. In this study, we present a rare case of a stone lodged in the hepaticojejunostomy of a patient with a history of pediatric Kasai and orthotropic liver transplant for biliary atresia, managed with enterotomy and stone extraction.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 10","pages":"e01846"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211405","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
Beyond the Biliary Tree: A Giant Calcified Rectal Fecalith Treated With Electrohydraulic Lithotripsy. 胆道树外：电液碎石治疗巨大钙化直肠粪石。
IF 0.5
ACG Case Reports Journal Pub Date : 2025-09-29 eCollection Date: 2025-10-01 DOI: 10.14309/crj.0000000000001835
Michael Gianarakis, Ameen Taufiq, Hasan S Raza, Omar T Ahmed, Parth Thaker, Jesse Hartpence, Brian Boulay
{"title":"Beyond the Biliary Tree: A Giant Calcified Rectal Fecalith Treated With Electrohydraulic Lithotripsy.","authors":"Michael Gianarakis, Ameen Taufiq, Hasan S Raza, Omar T Ahmed, Parth Thaker, Jesse Hartpence, Brian Boulay","doi":"10.14309/crj.0000000000001835","DOIUrl":"10.14309/crj.0000000000001835","url":null,"abstract":"<p><p>Chronic constipation and anorectal abnormalities can lead to the formation of fecaliths. Large, calcified fecaliths may pose significant clinical challenges when conservative treatments fail, including the risk of bowel perforation and hemorrhage. Although electrohydraulic lithotripsy (EHL) has been widely adopted for biliary and urinary calculi, its role in managing fecaliths remains rare. We report a 40-year-old woman with multiple sclerosis who presented with a large rectal fecalith successfully treated with EHL. This case underscores the potential of EHL as a minimally invasive procedure for calcified fecaliths, offering a safe alternative to surgery in patients at high risk for complications.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 10","pages":"e01835"},"PeriodicalIF":0.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197881","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
Drug-Induced Liver Injury Secondary to Radionuclide Therapy With Lutetium-177 Vipivotide Tetraxetan in a Patient With Metastatic Castrate-Resistant Prostate Cancer. 转移性去势抵抗性前列腺癌患者经放射性核素治疗后继发药物性肝损伤一例。
IF 0.5
ACG Case Reports Journal Pub Date : 2025-09-29 eCollection Date: 2025-10-01 DOI: 10.14309/crj.0000000000001845
Brian T Lee, Ravi J Kankotia, David Braxton
{"title":"Drug-Induced Liver Injury Secondary to Radionuclide Therapy With Lutetium-177 Vipivotide Tetraxetan in a Patient With Metastatic Castrate-Resistant Prostate Cancer.","authors":"Brian T Lee, Ravi J Kankotia, David Braxton","doi":"10.14309/crj.0000000000001845","DOIUrl":"10.14309/crj.0000000000001845","url":null,"abstract":"<p><p>Lutetium-177 vipivotide tetraxetan (LuPSMA) is a small molecule inhibitor with high affinity to prostate-specific membrane antigen and is currently used in the treatment of metastatic castrate-resistant prostate cancer. Hepatotoxicity has seldom been reported. This is a case of drug-induced liver injury presenting in a patient who received 5 cycles of LuPSMA for metastatic castrate-resistant prostate cancer. In this report, we provide a probable case of drug-induced liver injury with imaging and histologic findings of cholestatic liver injury and stricturing cholangiopathy related to LuPSMA. This is the first report of LuPSMA as a probable cause of hepatotoxicity.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 10","pages":"e01845"},"PeriodicalIF":0.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197869","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
Incidental Detection of Neoplastic B Cells in the Colon Following Resection in a Patient With Adenocarcinoma. 腺癌患者结肠切除术后肿瘤B细胞的偶然检测。
IF 0.5
ACG Case Reports Journal Pub Date : 2025-09-29 eCollection Date: 2025-10-01 DOI: 10.14309/crj.0000000000001844
Asrita Vattikonda, Hasan Saleh, Ian Dryden, Maoyin Pang
{"title":"Incidental Detection of Neoplastic B Cells in the Colon Following Resection in a Patient With Adenocarcinoma.","authors":"Asrita Vattikonda, Hasan Saleh, Ian Dryden, Maoyin Pang","doi":"10.14309/crj.0000000000001844","DOIUrl":"10.14309/crj.0000000000001844","url":null,"abstract":"<p><p>Following a routine screening colonoscopy, a 54-year-old man underwent colon resection for adenocarcinoma, which revealed neoplastic B-cells in the lymph nodes surrounding the colon suggestive of chronic lymphocytic leukemia (CLL). Further evaluation identified a monoclonal B-cell population, and he was diagnosed with monoclonal B-cell lymphocytosis without meeting CLL diagnostic criteria. The patient had no clinical signs of leukemia and did not need acute treatment but was placed under annual surveillance. This case highlights the incidental discovery of neoplastic B-cells, emphasizing the importance of comprehensive histopathological evaluation and clinical correlation to guide management and monitoring for potential progression to CLL.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 10","pages":"e01844"},"PeriodicalIF":0.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197903","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
Band Ligation-Assisted Histologic Surveillance of Barrett's Esophagus in the Setting of Esophageal Varices. 食管静脉曲张的结扎带辅助Barrett食管的组织学观察。
IF 0.5
ACG Case Reports Journal Pub Date : 2025-09-29 eCollection Date: 2025-10-01 DOI: 10.14309/crj.0000000000001848
Falak Hamo, Harsh Patel, Piyush Nathani, Nizar Talaat, Salih Samo
{"title":"Band Ligation-Assisted Histologic Surveillance of Barrett's Esophagus in the Setting of Esophageal Varices.","authors":"Falak Hamo, Harsh Patel, Piyush Nathani, Nizar Talaat, Salih Samo","doi":"10.14309/crj.0000000000001848","DOIUrl":"https://doi.org/10.14309/crj.0000000000001848","url":null,"abstract":"","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 10","pages":"e01848"},"PeriodicalIF":0.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197864","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
The Role of Transjugular Intrahepatic Portosystemic Shunt in Management of Peribiliary Varices. 经颈静脉肝内门静脉系统分流术在胆道周围静脉曲张治疗中的作用。
IF 0.5
ACG Case Reports Journal Pub Date : 2025-09-25 eCollection Date: 2025-09-01 DOI: 10.14309/crj.0000000000001839
Wael Mohamed, Mohamed Omar, David Maundu, Kyle Rowe
{"title":"The Role of Transjugular Intrahepatic Portosystemic Shunt in Management of Peribiliary Varices.","authors":"Wael Mohamed, Mohamed Omar, David Maundu, Kyle Rowe","doi":"10.14309/crj.0000000000001839","DOIUrl":"10.14309/crj.0000000000001839","url":null,"abstract":"<p><p>Peribiliary varices are a rare complication of chronic portal hypertension and can lead to common bile duct narrowing. Because of this, they can complicate the management of biliary obstruction secondary to choledocholithiasis. Instrumentation such as during endoscopic retrograde cholangiopancreatography poses the risk of severe hemorrhage. As such, decompressing the portal circulation via methods such as transjugular intrahepatic portosystemic shunt before attempted biliary stone extraction and sphincterotomy may be necessary to facilitate safe and successful treatment. This case demonstrates the crucial role of transjugular intrahepatic portosystemic shunt placement in enabling successful intervention in a challenging scenario where peribiliary varices obstructed access to the common bile duct.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 9","pages":"e01839"},"PeriodicalIF":0.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184475","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
Evidence of Altered Enteric Nervous System Structure Associated With Severe Dysmotility in a Patient With Ehlers-Danlos Syndrome. ehers - danlos综合征患者肠神经系统结构改变与严重运动障碍相关的证据。
IF 0.5
ACG Case Reports Journal Pub Date : 2025-09-24 eCollection Date: 2025-09-01 DOI: 10.14309/crj.0000000000001823
Karina Oelerich, Kanwal Bains, Scott B Minchenberg, Vikram Deshpande, Johanna Iturrino-Moreda, Subhash Kulkarni
{"title":"Evidence of Altered Enteric Nervous System Structure Associated With Severe Dysmotility in a Patient With Ehlers-Danlos Syndrome.","authors":"Karina Oelerich, Kanwal Bains, Scott B Minchenberg, Vikram Deshpande, Johanna Iturrino-Moreda, Subhash Kulkarni","doi":"10.14309/crj.0000000000001823","DOIUrl":"10.14309/crj.0000000000001823","url":null,"abstract":"<p><p>Patients with Ehlers-Danlos syndrome (EDS) suffer from gastroparesis, constipation, and gut dysmotility. We present a case of histopathological assessment of the enteric nervous system from an EDS patient with severe gut dysmotility. Full-thickness small bowel biopsies with immunostains for c-kit and S-100 within the myenteric plexus revealed no significant abnormality. Using the method by Boschetti et al of Neuronal Specific Enolase-based immunostaining, we found that interganglionic distance in the myenteric plexus (∼800 um) exceeded the normal range (380-570 µm). This clinical experience provides rationale for pursuing histopathology in patients with EDS.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 9","pages":"e01823"},"PeriodicalIF":0.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147511","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
Isolated Gastric Crohn's Disease. 孤立性胃克罗恩病
IF 0.5
ACG Case Reports Journal Pub Date : 2025-09-24 eCollection Date: 2025-09-01 DOI: 10.14309/crj.0000000000001790
Matthew Udine, Andres Rodriguez, Ankita Tirath, Heba Iskandar
{"title":"Isolated Gastric Crohn's Disease.","authors":"Matthew Udine, Andres Rodriguez, Ankita Tirath, Heba Iskandar","doi":"10.14309/crj.0000000000001790","DOIUrl":"10.14309/crj.0000000000001790","url":null,"abstract":"<p><p>Isolated gastric Crohn's Disease (IGCD) is a rare subset of Crohn's disease, poorly described in the literature. In this article, we present a 21-year-old man with gastric outlet obstruction secondary to IGCD. Management with Adalimumab and Upadacitinib failed, however he responded to Risankizumab. To our knowledge, this is the first case report documenting efficacy of Risankizumab in management of IGCD. In addition, we reviewed 13 published case reports describing IGCD. Ninety-two percent of cases were seen in women, typically presenting with nausea/vomiting and abdominal pain. Eighty-five percent of cases progressed to gastric outlet obstruction and tumor necrosis factor inhibitors were the first line advanced therapy.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 9","pages":"e01790"},"PeriodicalIF":0.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147449","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
When Cancer Erupts: Recognizing the Volcano Lesion in Gastric Metastases. 当癌症爆发：识别胃转移灶中的火山灶。
IF 0.5
ACG Case Reports Journal Pub Date : 2025-09-19 eCollection Date: 2025-09-01 DOI: 10.14309/crj.0000000000001836
Siri A Urquhart, Seth Sweetser
{"title":"When Cancer Erupts: Recognizing the Volcano Lesion in Gastric Metastases.","authors":"Siri A Urquhart, Seth Sweetser","doi":"10.14309/crj.0000000000001836","DOIUrl":"10.14309/crj.0000000000001836","url":null,"abstract":"","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 9","pages":"e01836"},"PeriodicalIF":0.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111727","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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