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Cytomegalovirus Enteritis: A Rare Culprit of Protein Losing Enteropathy in an Immunocompetent Adult. 巨细胞病毒肠炎：一种罕见的罪魁祸首蛋白质丧失肠病在免疫正常的成年人。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-07-21 eCollection Date: 2025-07-01 DOI: 10.14309/crj.0000000000001768
Nancy Mayer, Vijay Kata, Dhaval Patel, Daniel Errampalli, Thomas O'Connor, Matthew Kaplan, Thomas Betlej, Nikhil Bhargava
{"title":"Cytomegalovirus Enteritis: A Rare Culprit of Protein Losing Enteropathy in an Immunocompetent Adult.","authors":"Nancy Mayer, Vijay Kata, Dhaval Patel, Daniel Errampalli, Thomas O'Connor, Matthew Kaplan, Thomas Betlej, Nikhil Bhargava","doi":"10.14309/crj.0000000000001768","DOIUrl":"10.14309/crj.0000000000001768","url":null,"abstract":"<p><p>Protein-losing enteropathy (PLE) is a rare complication of cytomegalovirus (CMV) enteritis in immunocompetent individuals. We present a case of a previously healthy 60-year-old woman with an acute CMV infection, manifesting as intractable vomiting and diarrhea, refractory electrolyte disturbances, and anasarca. The diagnostic evaluation showed low serum protein levels and an increased fecal alpha-1 antitrypsin clearance, confirming PLE. CMV-specific immunohistochemistry on duodenal samples subsequently confirmed that the PLE was caused by CMV enteritis. She completed treatment with valganciclovir for 3 weeks, resulting in symptom resolution and normalization of endoscopic findings. This case highlights the importance of recognizing CMV-associated PLE, particularly in immunocompetent individuals, for timely diagnosis and treatment.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 7","pages":"e01768"},"PeriodicalIF":0.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681754","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 Overlap of Autoimmune Pancreatitis and Pancreatic Cancer: A Clinical Challenge. 自身免疫性胰腺炎和胰腺癌的重叠：一个临床挑战
IF 0.6
ACG Case Reports Journal Pub Date : 2025-07-21 eCollection Date: 2025-07-01 DOI: 10.14309/crj.0000000000001773
Abdelrahman Yakout, Daniela Fluxa, Aziza Nassar, Victoria Gomez
{"title":"The Overlap of Autoimmune Pancreatitis and Pancreatic Cancer: A Clinical Challenge.","authors":"Abdelrahman Yakout, Daniela Fluxa, Aziza Nassar, Victoria Gomez","doi":"10.14309/crj.0000000000001773","DOIUrl":"10.14309/crj.0000000000001773","url":null,"abstract":"<p><p>Autoimmune pancreatitis (AIP) and pancreatic cancer share clinical and radiological features, making biopsy the only definitive way of differentiating them. Numerous reports in the literature describe the co-occurrence of AIP and pancreatic cancer either in a synchronous manner or metachronous manner raising the question of which condition predisposes to the other and whether a causal relationship exists between them. Studies suggest shared mechanisms, including K-ras mutations and tumor suppressor gene silencing. This case highlights the importance of long-term surveillance in AIP patients to monitor for malignancy.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 7","pages":"e01773"},"PeriodicalIF":0.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681757","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 Rare Case of A Pseudosarcomatous Stromal Tumor: A Unique Benign Ampullary Tumor. 一例罕见的假肉瘤间质肿瘤：一种独特的良性壶腹部肿瘤。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-07-21 eCollection Date: 2025-07-01 DOI: 10.14309/crj.0000000000001767
Jacob C Jones, Penelope I Quiles, John G Quiles, Jerome G Edelson
{"title":"A Rare Case of A Pseudosarcomatous Stromal Tumor: A Unique Benign Ampullary Tumor.","authors":"Jacob C Jones, Penelope I Quiles, John G Quiles, Jerome G Edelson","doi":"10.14309/crj.0000000000001767","DOIUrl":"10.14309/crj.0000000000001767","url":null,"abstract":"<p><p>We present a case of a pseudosarcomatous stromal proliferation of the ampullary and duodenal mucosa and its treatment in an asymptomatic 61-year-old man with a history of prostate adenocarcinoma and carotid paraganglioma. There is a modicum of literature describing these cases and treatment involving the gastrointestinal tract. The intricacy of diagnosis can further complicate management which necessitates the need for discussion between the clinician and the pathologist to avoid unnecessary invasive intervention. Our example of a pseudosarcoma involving the ampullary and duodenal mucosa and its treatment is unprecedented, therefore, should serve as an example for similar cases.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 7","pages":"e01767"},"PeriodicalIF":0.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688609","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
Pembrolizumab-Induced Duodenitis Mimicking Celiac Disease. pembrolizumab诱导的模拟乳糜泻的十二指肠炎。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-07-21 eCollection Date: 2025-07-01 DOI: 10.14309/crj.0000000000001756
Yannis Lafazanos, Robin David, Nahren Asado, Miguel Gonzalez, Eli D Ehrenpreis
{"title":"Pembrolizumab-Induced Duodenitis Mimicking Celiac Disease.","authors":"Yannis Lafazanos, Robin David, Nahren Asado, Miguel Gonzalez, Eli D Ehrenpreis","doi":"10.14309/crj.0000000000001756","DOIUrl":"10.14309/crj.0000000000001756","url":null,"abstract":"<p><p>Pembrolizumab is a programmed cell death-1 (PD-1) inhibitor frequently used as primary immunotherapy in many cancers, including melanoma, lung, renal cell, cervical, urothelial, and gastric cancers. Given its immune-checkpoint inhibition and upregulation of the immune response, pembrolizumab has been associated with many immune system-related adverse effects including stomatitis, conjunctivitis, pneumonitis, myositis, and even type 1 diabetes mellitus. Colitis is the most frequent gastrointestinal adverse reaction, with upper gastrointestinal reactions like esophagitis, gastritis, and duodenitis being rare. In this report, we present a case of pembrolizumab-induced enteropathy that endoscopically and histologically mimicked celiac disease.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 7","pages":"e01756"},"PeriodicalIF":0.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681756","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
Stealth Erosion: A Rare Case of Gastric Band Complication 2 Decades Postimplantation With a Prolonged and Complex Hospital Course. 隐蔽性糜烂：胃束并发症1例，植胃后20年，病程长而复杂。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-07-18 eCollection Date: 2025-07-01 DOI: 10.14309/crj.0000000000001770
Karan J Yagnik, Suryansh Atreya, Pranay Joshi, Sankalp Acharya, Dharmesh Kaswala, Wael Ghali
{"title":"Stealth Erosion: A Rare Case of Gastric Band Complication 2 Decades Postimplantation With a Prolonged and Complex Hospital Course.","authors":"Karan J Yagnik, Suryansh Atreya, Pranay Joshi, Sankalp Acharya, Dharmesh Kaswala, Wael Ghali","doi":"10.14309/crj.0000000000001770","DOIUrl":"10.14309/crj.0000000000001770","url":null,"abstract":"<p><p>A woman in her 60s presented with epigastric pain and fever, initially managed as acute cholecystitis. Imaging was inconclusive, but esophagogastroduodenoscopy on hospital day 4 revealed gastric band erosion 20 years postlaparoscopic adjustable gastric banding. Surgery confirmed partial erosion with abscess along the band tract and subcutaneous port site. Postoperative complications included gastric leak, candida infection, and abdominal wall abscess, managed with antibiotics, drainage, and supportive care. She was later discharged on oral antibiotics but developed a pulmonary embolism requiring anticoagulation. Laparoscopic adjustable gastric banding complications, including erosion, should be considered even decades later; early endoscopy may prevent delays and related complications.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 7","pages":"e01770"},"PeriodicalIF":0.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673707","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
An Elusive Case of Arterial Appendiceal Bleeding: Diagnostic and Therapeutic Insights. 阑尾动脉性出血一例：诊断和治疗见解。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-07-18 eCollection Date: 2025-07-01 DOI: 10.14309/crj.0000000000001778
Seema Belani, Janki Luther, Surachai Amornsawadwattana, Judy Trieu
{"title":"An Elusive Case of Arterial Appendiceal Bleeding: Diagnostic and Therapeutic Insights.","authors":"Seema Belani, Janki Luther, Surachai Amornsawadwattana, Judy Trieu","doi":"10.14309/crj.0000000000001778","DOIUrl":"10.14309/crj.0000000000001778","url":null,"abstract":"<p><p>We present a case of hematochezia because of a small arterial bleed endoscopically seen at the appendiceal orifice. The bleed was slowed with hemostatic clip placement, which allowed for preoperative imaging and appropriate resuscitation. The patient was taken for definitive laparoscopic appendectomy with complete resolution of gastrointestinal bleeding.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 7","pages":"e01778"},"PeriodicalIF":0.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673705","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
Gastrojejunal Anastomosis Adenocarcinoma Occurring After Trans-Oral Revision for Weight Recurrence After Roux-en-Y Gastric Bypass. 胃空肠吻合术Roux-en-Y胃旁路术后体重复发经口改良后发生的腺癌。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-07-18 eCollection Date: 2025-07-01 DOI: 10.14309/crj.0000000000001775
Yara Salameh, Hadi K Abou Zeid, Khushboo S Gala, Roopa Kumari, Andrew C Storm
{"title":"Gastrojejunal Anastomosis Adenocarcinoma Occurring After Trans-Oral Revision for Weight Recurrence After Roux-en-Y Gastric Bypass.","authors":"Yara Salameh, Hadi K Abou Zeid, Khushboo S Gala, Roopa Kumari, Andrew C Storm","doi":"10.14309/crj.0000000000001775","DOIUrl":"10.14309/crj.0000000000001775","url":null,"abstract":"<p><p>Weight recurrence is a late complication after Roux-en-Y gastric bypass. The transoral outlet reduction (TORe) emerged as an endoscopic alternative to revisional surgery for weight recurrence due to a dilated and incompetent gastrojejunal anastomosis. The procedure has been documented as safe and effective in clinical trials and other high-quality medical literature. Several cases of squamous metaplasia of the gastric pouch after repeated TORe procedures using argon plasma coagulation have been reported. We present a case of a late-onset adenocarcinoma of the gastrojejunal anastomosis after a TORe procedure performed using argon plasma coagulation and suturing.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 7","pages":"e01775"},"PeriodicalIF":0.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673706","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
Tacrolimus-Induced Acute Esophageal Necrosis Postorthotopic Liver Transplantation. 他克莫司致肝移植后急性食管坏死。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-07-18 eCollection Date: 2025-07-01 DOI: 10.14309/crj.0000000000001772
Wei Tang, Makeda Dawkins, Daniel Basta, Nao Hara, Fouzia Shakil, Bodin Roxana, Shireen Pais, Kenji Okumura, Seigo Nishida, Abhay Dhand
{"title":"Tacrolimus-Induced Acute Esophageal Necrosis Postorthotopic Liver Transplantation.","authors":"Wei Tang, Makeda Dawkins, Daniel Basta, Nao Hara, Fouzia Shakil, Bodin Roxana, Shireen Pais, Kenji Okumura, Seigo Nishida, Abhay Dhand","doi":"10.14309/crj.0000000000001772","DOIUrl":"10.14309/crj.0000000000001772","url":null,"abstract":"<p><p>Acute esophageal necrosis, or \"black esophagus,\" is a rare but severe condition characterized by circumferential black necrotized esophageal mucosa with an abrupt transition at the gastroesophageal junction. The \"two-hit\" hypothesis suggests that an initial ischemic insult predisposes the esophageal mucosa to further injury from luminal acid exposure or medications. We present the first documented case of tacrolimus-induced acute esophageal necrosis without preceding hemodynamic instability in a liver transplant recipient, which resolved with discontinuation of tacrolimus and transition to cyclosporin.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 7","pages":"e01772"},"PeriodicalIF":0.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673708","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
Leave No "Stone" Unturned: Biliary Obstruction From Isolated Intraductal Metastatic HCC. 胆道梗阻：孤立性导管内转移性HCC引起的胆道梗阻。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-07-17 eCollection Date: 2025-07-01 DOI: 10.14309/crj.0000000000001766
Shivani Desai, Katrina A McGinty, Andrew Canakis, Lee-Ching Zhu, Neil D Shah
{"title":"Leave No \"Stone\" Unturned: Biliary Obstruction From Isolated Intraductal Metastatic HCC.","authors":"Shivani Desai, Katrina A McGinty, Andrew Canakis, Lee-Ching Zhu, Neil D Shah","doi":"10.14309/crj.0000000000001766","DOIUrl":"10.14309/crj.0000000000001766","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) metastases to the biliary tree are exceedingly rare. We present a patient with hepatitis C virus (HCV) cirrhosis and recurrent HCC treated previously by locoregional therapy, who presented for Y-90 embolization but was found to have obstructive jaundice. Intraductal biopsy confirmed isolated, metastatic HCC in the distal common bile duct leading to obstruction. Albeit rare, bile duct metastases should be considered in patients with HCC treated by locoregional therapy presenting with obstructive jaundice. To our knowledge, this is the first report of metastatic HCC to the common bile duct in a patient who has not undergone prior partial hepatectomy.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 7","pages":"e01766"},"PeriodicalIF":0.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658118","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
Over-The-Scope Clip Misdeployment Resulting in Acute Cholangitis and Biliary Pancreatitis. 急性胆管炎和胆源性胰腺炎的超镜夹错布。
IF 0.6
ACG Case Reports Journal Pub Date : 2025-07-14 eCollection Date: 2025-07-01 DOI: 10.14309/crj.0000000000001765
Aniruddha Srivastava, Luay M Almassalha, Laurens P Janssens, Srinadh Komanduri, Saad Saffo
{"title":"Over-The-Scope Clip Misdeployment Resulting in Acute Cholangitis and Biliary Pancreatitis.","authors":"Aniruddha Srivastava, Luay M Almassalha, Laurens P Janssens, Srinadh Komanduri, Saad Saffo","doi":"10.14309/crj.0000000000001765","DOIUrl":"10.14309/crj.0000000000001765","url":null,"abstract":"<p><p>Over-the-scope clips (OTSCs) have improved the endoscopic management of acute nonvariceal upper gastrointestinal bleeding. They allow for effective hemostasis of high-risk lesions in challenging locations and have been shown to be superior to through-the-scope clips. However, misdeployment of OTSCs may be associated with obstructive complications. In this study, we present the case of a 67-year-old man who developed recurrent gastrointestinal bleeding from a duodenal ulcer. His course was ultimately complicated by acute cholangitis and pancreatitis from a misdeployed OTSC around the ampulla. Endoscopic management was pursued, and the clip was successfully retracted with resolution of his biliary obstruction and subsequent clinical improvement.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 7","pages":"e01765"},"PeriodicalIF":0.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641486","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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