ACG Case Reports JournalPub Date : 2024-08-23eCollection Date: 2024-08-01DOI: 10.14309/crj.0000000000001469
Azhar Hussain, Vishnu Charan Suresh Kumar, Hafiz Muzaffar Akbar Khan
{"title":"Single-Session Endoscopic Ultrasound-Directed Transgastric Endoscopic Retrograde Cholangiopancreatography and Simultaneous Endoscopic Ultrasound-Guided Transmural Gallbladder Drainage in Choledocholithiasis and Acute Cholecystitis After Unsuccessful Laparoscopic Cholecystectomy.","authors":"Azhar Hussain, Vishnu Charan Suresh Kumar, Hafiz Muzaffar Akbar Khan","doi":"10.14309/crj.0000000000001469","DOIUrl":"10.14309/crj.0000000000001469","url":null,"abstract":"<p><p>In patients considered high risk of laparoscopic cholecystectomy, percutaneous gallbladder drainage is traditionally considered first-line treatment option. Recent evidence supports endoscopic gallbladder drainage as a safe and feasible alternate option. We describe a case of Roux-en-Y gastric bypass surgery patient with acute cholecystitis and choledocholithiasis with unsuccessful laparoscopic cholecystectomy because of difficult operative field, underwent successful single-session endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography and endoscopic ultrasound-guided transmural gallbladder drainage at our institution.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 8","pages":"e01469"},"PeriodicalIF":0.6,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054648","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}
ACG Case Reports JournalPub Date : 2024-08-22eCollection Date: 2024-08-01DOI: 10.14309/crj.0000000000001458
Mariyam Sadikot, Gunter Nicolle
{"title":"Coexisting Organoaxial Gastric Volvulus and Sigmoid Volvulus With Complications.","authors":"Mariyam Sadikot, Gunter Nicolle","doi":"10.14309/crj.0000000000001458","DOIUrl":"10.14309/crj.0000000000001458","url":null,"abstract":"<p><p>Very few cases of coexisting organoaxial gastric and sigmoid volvuli have been reported. In here we describe 1 such case. Our patient, a 92-year-old man, was treated with a flexible sigmoidoscopy with decompression for his sigmoid volvulus. For the gastric volvulus, the patient was initially treated with an upper endoscopic gastric decompression and subsequently treated with a laparoscopic anterior gastropexy. After the gastropexy, the patient developed bleeding and ischemia of the stomach, which is a rare complication due to the stomach's rich blood supply. This case report reiterates the need to consider rare complications in patients with such rare pathologies.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 8","pages":"e01458"},"PeriodicalIF":0.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034406","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}
ACG Case Reports JournalPub Date : 2024-08-22eCollection Date: 2024-08-01DOI: 10.14309/crj.0000000000001460
Thomas Skinner, Sharron Liang, Santosh Sanagapalli
{"title":"Budesonide Orodispersible Tablet for the Treatment of Refractory Esophageal Lichen Planus.","authors":"Thomas Skinner, Sharron Liang, Santosh Sanagapalli","doi":"10.14309/crj.0000000000001460","DOIUrl":"10.14309/crj.0000000000001460","url":null,"abstract":"<p><p>Esophageal lichen planus is an uncommon but highly morbid condition where effective treatments are limited. Diagnosis may be challenging and requires a high degree of clinical suspicion considering endoscopic, histopathological, esophageal, and extraesophageal manifestations. We describe a severe case of esophageal lichen planus and recurrent esophageal stricture that was refractory to acid suppression, local and systemic steroid formulations, and dilatation. We present the first reported use of budesonide orodispersible tablet for this condition, including the excellent clinical, endoscopic, and histopathological response.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 8","pages":"e01460"},"PeriodicalIF":0.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034877","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}
ACG Case Reports JournalPub Date : 2024-08-22eCollection Date: 2024-08-01DOI: 10.14309/crj.0000000000001467
Wei Tang, Zilan Lin, Pritika Sharma, Gabriel Heering, Brad Dworkin, Amir Steinberg, Fouzia Shakil, Beth Schorr-Lesnick
{"title":"Gastrointestinal Alpha Heavy Chain Disease With Persistent <i>Campylobacter Jejuni</i> Colonization and Refractory Giardiasis.","authors":"Wei Tang, Zilan Lin, Pritika Sharma, Gabriel Heering, Brad Dworkin, Amir Steinberg, Fouzia Shakil, Beth Schorr-Lesnick","doi":"10.14309/crj.0000000000001467","DOIUrl":"10.14309/crj.0000000000001467","url":null,"abstract":"<p><p>Alpha heavy chain disease (αHCD) is a rare variant of the mucosa-associated lymphoid tissue lymphoma characterized by expression of a monotypic truncated immunoglobulin α heavy chain. αHCD frequently involves the gastrointestinal (GI) tract, and its pathogenesis has been linked to clonal B-cell expansion from chronic immune stimulation by infectious agents. We report a rare case of GI αHCD with 5 concomitant pathogens identified on a GI multiplex real-time polymerase chain reaction panel, featured by persistent <i>Campylobacter jejuni</i> colonization and refractory giardiasis.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 8","pages":"e01467"},"PeriodicalIF":0.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034878","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}
ACG Case Reports JournalPub Date : 2024-08-22eCollection Date: 2024-08-01DOI: 10.14309/crj.0000000000001465
Frank Lin, Janak Bahirwani, Lisa Stoll, Sarina Kapoor
{"title":"Endometriosis of the Colon and Pericolic Lymph Nodes Presenting as Cecal Volvulus.","authors":"Frank Lin, Janak Bahirwani, Lisa Stoll, Sarina Kapoor","doi":"10.14309/crj.0000000000001465","DOIUrl":"10.14309/crj.0000000000001465","url":null,"abstract":"<p><p>Endometriosis, characterized by the ectopic implantation of endometrial tissue, typically involves pelvic structures but infrequently extends to extrapelvic sites such as the gastrointestinal tract. In this report, we present a case of a 44-year-old woman with diffuse abdominal discomfort and constipation. Computed tomography imaging revealed a mass in the cecum, leading to diagnostic colonoscopy and subsequent magnetic resonance imaging. Ultimately, laparoscopy revealed a puckered cecal mass suspected to be invasive malignancy but pathologically confirmed as extensive endometriosis involving the colonic wall and pericolic lymph nodes. Cecal volvulus secondary to endometriosis is exceedingly rare, with surgical intervention being the primary treatment modality. Endometriosis-associated gastrointestinal involvement often masquerades as irritable bowel syndrome, highlighting the importance of considering atypical presentations in young women. This case underscores the need to maintain a high index of suspicion for unusual etiologies in patients with gastrointestinal symptoms and atypical imaging findings to facilitate timely diagnosis and management.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 8","pages":"e01465"},"PeriodicalIF":0.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034407","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}
ACG Case Reports JournalPub Date : 2024-08-22eCollection Date: 2024-08-01DOI: 10.14309/crj.0000000000001471
Ayesha Khan, Julia Hawes, Julia Zhang, Ahmed Khan, Karen Szauter, Maryamnaz Falamaki, Michael L Kueht, Luca Cicalese, Sreeram Parupudi
{"title":"Necrotizing Pancreatitis After Bland Embolization of a Large Hepatic Hemangioma.","authors":"Ayesha Khan, Julia Hawes, Julia Zhang, Ahmed Khan, Karen Szauter, Maryamnaz Falamaki, Michael L Kueht, Luca Cicalese, Sreeram Parupudi","doi":"10.14309/crj.0000000000001471","DOIUrl":"10.14309/crj.0000000000001471","url":null,"abstract":"<p><p>Liver embolization is a common procedure for management of liver lesions. Embolization can be performed using only an embolic material or along with chemotherapy agents. Infrequent complications seen postliver embolization include pulmonary thromboembolism, hepatic infarct, liver abscess, liver failure, ischemic biliary strictures, and less frequently pancreatic damage (incidence of 1.7%). We describe a case of necrotizing pancreatitis after bland embolization of a large hepatic hemangioma. The exact mechanisms of acute pancreatitis after liver embolization are uncertain, although direct ischemic mechanisms, toxic effects of antineoplastic agents, and volume of embospheres used are believed to play a role.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 8","pages":"e01471"},"PeriodicalIF":0.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034881","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}
ACG Case Reports JournalPub Date : 2024-08-22eCollection Date: 2024-08-01DOI: 10.14309/crj.0000000000001456
Julian Cardinal von Widdern, Franz Stangl, Walter A Wohlgemuth, Richard Brill, Jörg Kleeff, Jonas Rosendahl
{"title":"Persisting Cutaneous Pancreatic Fistula in a Patient With Necrotizing Pancreatitis: A Novel Approach of Transfistulous Histoacryl Occlusion.","authors":"Julian Cardinal von Widdern, Franz Stangl, Walter A Wohlgemuth, Richard Brill, Jörg Kleeff, Jonas Rosendahl","doi":"10.14309/crj.0000000000001456","DOIUrl":"10.14309/crj.0000000000001456","url":null,"abstract":"<p><p>Necrotizing pancreatitis with superinfection of necrotic tissue is associated with a high rate of complications and mortality. The step-up approach is a well-established treatment strategy for necrotizing pancreatitis, emphasizing minimally invasive and endoscopic interventions before considering surgical options. Minimally invasive strategies often involve percutaneous drainage of collections, which carries the risk of persisting cutaneous pancreatic fistulas. Since there is currently no guidance for managing this scenario, we present a novel treatment approach that utilized tissue glue to occlude a persisting and clinically compromising percutaneous fistula. In addition, we summarize the current knowledge in the treatment of percutaneous pancreatic fistulas and provide a potential therapeutic algorithm for further evaluation.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 8","pages":"e01456"},"PeriodicalIF":0.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034882","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}
ACG Case Reports JournalPub Date : 2024-08-22eCollection Date: 2024-08-01DOI: 10.14309/crj.0000000000001474
Taha Bin Arif, Bedoor Alabbas, Rakesh Vinayek
{"title":"Upper Gastrointestinal Bleeding Due to Metastatic Lung Adenocarcinoma in the Stomach and Duodenum.","authors":"Taha Bin Arif, Bedoor Alabbas, Rakesh Vinayek","doi":"10.14309/crj.0000000000001474","DOIUrl":"10.14309/crj.0000000000001474","url":null,"abstract":"<p><p>There are very few reports of bloodborne metastasis of lung adenocarcinoma to the gastrointestinal tract, primarily due to poor prognosis and short survival rate of metastasized carcinoma. We present a case of a 79-year-old man with a medical history of lung adenocarcinoma, who presented with complaints of weakness and melena for 1 week. He had symptomatic anemia, for which he was transfused with blood. Esophagogastroduodenoscopy showed a 10 mm sessile polyp in the gastric body that was removed. One month later, the patient presented with a similar complaint, and another esophagogastroduodenoscopy revealed 2 ulcerated lesions in the second portion of the duodenum. These lesions were treated by hemostatic clip placement and heater probe coagulation. Biopsy of lesions demonstrated thyroid transcription factor 1 and Napsin-positive tumor cells, consistent with lung adenocarcinoma. Owing to the poor prognosis of lung adenocarcinoma metastasizing to the lymph nodes, stomach, and duodenum, the patient was transferred to hospice care.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 8","pages":"e01474"},"PeriodicalIF":0.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034884","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":"Successful Hemostasis Using Fully Covered Self-Expanding Metallic Stent for Spontaneous Hemobilia in a Child With Portal Cavernoma Cholangiopathy.","authors":"Arghya Samanta, Anshu Srivastava, Samir Mohindra, Rajanikant Yadav, Ujjal Poddar, Moinak Sen Sarma, Basant Kumar","doi":"10.14309/crj.0000000000001473","DOIUrl":"10.14309/crj.0000000000001473","url":null,"abstract":"<p><p>Portal cavernoma cholangiopathy refers to changes in the intrahepatic and extrahepatic biliary ducts in patients with extrahepatic portal venous obstruction. Spontaneous hemobilia in the setting of portal cavernoma cholangiopathy is extremely rare, and it poses diagnostic as well as therapeutic challenge. Here, we report the case of a 10-year-old girl with extrahepatic portal venous obstruction, who presented with hemobilia. Computed tomography angiography of abdomen and endoscopic ultrasound confirmed the presence of pericholedochal, paracholedochal, and intracholedochal varices. Hemostasis was achieved with the placement of a fully covered self-expanding metallic stent into the common bile duct. Fully covered self-expanding metallic stent is safe and effective for control of bleeding in children presenting with hemobilia.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 8","pages":"e01473"},"PeriodicalIF":0.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034883","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}
ACG Case Reports JournalPub Date : 2024-08-22eCollection Date: 2024-08-01DOI: 10.14309/crj.0000000000001466
Anthony J Mauro, Phoenix D Bell, Kevin McGrath
{"title":"Gastrointestinal Follicular Lymphoma of the Cecum Treated via Endoscopic Full-Thickness Resection.","authors":"Anthony J Mauro, Phoenix D Bell, Kevin McGrath","doi":"10.14309/crj.0000000000001466","DOIUrl":"10.14309/crj.0000000000001466","url":null,"abstract":"<p><p>Gastrointestinal follicular lymphoma (GI-FL) is an uncommon non-Hodgkin lymphoma that affects the gastrointestinal tract. It typically occurs within the duodenum with the appearance of multiple nodules. Treatment options, depending on stage and grade of the tumor, include aggressive chemotherapy, immunotherapy, radiotherapy, surgical or endoscopic resection, or simply monitoring as focal disease may be indolent. We present a rare case of a GI-FL presenting as a solitary lesion within the cecum treated via endoscopic full-thickness resection using the Ovesco full-thickness resection device. This case demonstrates the effectiveness of endoscopic full-thickness resection in treating small GI-FL in the colon.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 8","pages":"e01466"},"PeriodicalIF":0.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034879","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}