ACG Case Reports JournalPub Date : 2025-05-02eCollection Date: 2025-05-01DOI: 10.14309/crj.0000000000001699
Mathew Vadukoot Lazar, George Sarin Zacharia, Krishnanmurthy Subbian, Jibu Thomas
{"title":"A Semantic Surprise in Colon: <i>Gastrodiscoides hominis</i>.","authors":"Mathew Vadukoot Lazar, George Sarin Zacharia, Krishnanmurthy Subbian, Jibu Thomas","doi":"10.14309/crj.0000000000001699","DOIUrl":"https://doi.org/10.14309/crj.0000000000001699","url":null,"abstract":"<p><p>Human gastrodiscoidiasis is a rare, geographically restricted trematode infection caused by <i>Gastrodiscoides hominis</i>, an amphistome platyhelminth, also known as the colon fluke. The disease is endemic to Assam in northeastern India, although sporadic cases have been reported in other Asian countries and across different continents. The disease primarily affects the right colon, leading to epithelial desquamation, inflammation, and increased secretion of colonic mucus. We report the case of a 30-year-old Indian man with a history of cramping lower abdominal pain, increased stool frequency, and weight loss, with an inflammatory pattern on routine stool analysis, detected to have multiple platyhelminths adherent to the cecum and ascending colon, subsequently confirmed microbiologically as <i>G. hominis</i> and effectively treated with mebendazole. Our case highlights the importance of considering rare helminthic infections in patients with chronic gastrointestinal symptoms, particularly those from endemic areas, and the role of colonoscopy in confirming the diagnosis and guiding treatment.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 5","pages":"e01699"},"PeriodicalIF":0.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955025","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 : 2025-05-02eCollection Date: 2025-05-01DOI: 10.14309/crj.0000000000001692
Simone Chin, Matthew Choy, Peter De Cruz
{"title":"Tofacitinib in Stricturing Colonic Crohn's Disease.","authors":"Simone Chin, Matthew Choy, Peter De Cruz","doi":"10.14309/crj.0000000000001692","DOIUrl":"https://doi.org/10.14309/crj.0000000000001692","url":null,"abstract":"<p><p>Tofacitinib has described efficacy in ulcerative colitis but not Crohn's disease (CD). However, patients with stricturing CD were excluded from initial randomized controlled trials. We report a case of stricturing colonic CD, which responded to tofacitinib therapy.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 5","pages":"e01692"},"PeriodicalIF":0.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956856","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 : 2025-05-02eCollection Date: 2025-05-01DOI: 10.14309/crj.0000000000001691
Hasan Jaber, Meagan Phox, Nader Al Souky, Kevin Kadado, Wael Mohamed, Kyle Rowe
{"title":"Malignant Common Bile Duct Stricture Secondary to Metastatic Squamous Cell Carcinoma of the Cervix.","authors":"Hasan Jaber, Meagan Phox, Nader Al Souky, Kevin Kadado, Wael Mohamed, Kyle Rowe","doi":"10.14309/crj.0000000000001691","DOIUrl":"https://doi.org/10.14309/crj.0000000000001691","url":null,"abstract":"<p><p>Squamous cell carcinoma of the cervix (SCCC) commonly metastasizes to lymph nodes, lungs, liver, and bones, but involvement of the biliary system is rare. We present a 39-year-old woman with a history of stage IVa SCCC in remission for 18 months who developed obstructive jaundice due to a common bile duct stricture. Endoscopic retrograde cholangiopancreatography with cholangioscopy confirmed metastatic SCCC. This case highlights a rare manifestation of SCCC presenting with biliary obstruction, even at uncommon metastatic sites.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 5","pages":"e01691"},"PeriodicalIF":0.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955742","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 : 2025-04-30eCollection Date: 2025-05-01DOI: 10.14309/crj.0000000000001690
Vincent Hou, Thomas Enke, Augustin Attwell
{"title":"Diagnosis of Recurrent Esophageal Adenocarcinoma Using Esophageal Ultrasound-Guided Fine-Needle Aspiration of a Pleural Effusion.","authors":"Vincent Hou, Thomas Enke, Augustin Attwell","doi":"10.14309/crj.0000000000001690","DOIUrl":"https://doi.org/10.14309/crj.0000000000001690","url":null,"abstract":"","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 5","pages":"e01690"},"PeriodicalIF":0.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058284","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 : 2025-04-30eCollection Date: 2025-05-01DOI: 10.14309/crj.0000000000001680
Misha Gautam, Vinay Jahagirdar, Kimia Zoraghchi, Thomas Cunningham, Mohamed Ahmed, Ben Aziz, Nathan Saucier, John P Campbell
{"title":"Atypical Endoscopic Appearance of a Rare Cause of Gastrointestinal Bleeding: Superior Mesenteric Vein Occlusion Causing Colon Varices.","authors":"Misha Gautam, Vinay Jahagirdar, Kimia Zoraghchi, Thomas Cunningham, Mohamed Ahmed, Ben Aziz, Nathan Saucier, John P Campbell","doi":"10.14309/crj.0000000000001680","DOIUrl":"https://doi.org/10.14309/crj.0000000000001680","url":null,"abstract":"<p><p>Colonic varices (CV) are an uncommon cause of gastrointestinal bleeding, with an incidence of only 0.07%. We present a case of a 34-year-old woman with chronic superior mesenteric vein occlusion after pancreatoduodenectomy, leading to diffuse colonic varices with an atypical appearance needing further evaluation. Subsequent angiography confirmed CV, which were treated with catheter-based superior mesenteric vein stenting and variceal coiling. The patient's bleeding was controlled, with plans for continued surveillance. This case emphasizes the diagnostic challenges, treatment complexities, and the need for individualized management strategies for CV, highlighting the urgent need for established guidelines.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 5","pages":"e01680"},"PeriodicalIF":0.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958624","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 : 2025-04-25eCollection Date: 2025-05-01DOI: 10.14309/crj.0000000000001674
Alejandro A Rodriguez, Shyam Vedantam, Camilo J Acosta, Sean Bhalla, Jodie A Barkin
{"title":"Pancreatic Cancer Solitary Metastasis to Colon is a Rare Entity.","authors":"Alejandro A Rodriguez, Shyam Vedantam, Camilo J Acosta, Sean Bhalla, Jodie A Barkin","doi":"10.14309/crj.0000000000001674","DOIUrl":"https://doi.org/10.14309/crj.0000000000001674","url":null,"abstract":"<p><p>Metastases in pancreatic ductal adenocarcinoma are present in over 50% of cases at the time of diagnosis, with the liver, peritoneum, and lung being some of the most common sites. By contrast, solitary distant metastasis to the colon is a rare entity but clinically significant. We report 2 cases of synchronous pancreatic ductal adenocarcinoma distant metastasis to colon along with a literature review. Our cases demonstrate the utility of colonoscopy to diagnose metastatic disease. Last, as highlighted, palliative stenting can be used in cases of complete obstruction. <b>KEYWORDS</b>: pancreatic cancer; metastasis; obstruction; malignant large bowel obstruction; colonoscopy.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 5","pages":"e01674"},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961777","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 : 2025-04-25eCollection Date: 2025-05-01DOI: 10.14309/crj.0000000000001679
Bianca Thakkar, Minh Thu T Nguyen, Rachael Hagen, Neil Parikh
{"title":"From Glycemic Control to Gut Telescoping: Intussusception in a Patient on a Glucagon-Like Peptide-1 Receptor Agonist.","authors":"Bianca Thakkar, Minh Thu T Nguyen, Rachael Hagen, Neil Parikh","doi":"10.14309/crj.0000000000001679","DOIUrl":"https://doi.org/10.14309/crj.0000000000001679","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely utilized for managing diabetes and obesity due to their efficacy in improving glycemic control and promoting weight loss. However, their gastrointestinal effects, such as slowed motility, may lead to adverse outcomes, including small bowel obstruction. Intussusception, a rare complication in adults, has been sparsely reported with GLP-1RA use. We present a 32-year-old woman with iron deficiency anemia who was incidentally diagnosed with transient small bowel intussusception on computed tomography enterography while on semaglutide therapy. No evidence of obstruction or pathological lead point was identified, and follow-up imaging showed resolution without intervention. This case suggests a possible link between GLP-1RA therapy and intussusception, likely secondary to altered gastrointestinal motility. Clinicians should remain vigilant for rare complications associated with GLP-1RAs, particularly in patients presenting with gastrointestinal symptoms. Further studies are warranted to elucidate this association.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 5","pages":"e01679"},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955078","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 : 2025-04-25eCollection Date: 2025-05-01DOI: 10.14309/crj.0000000000001686
Shivangini Duggal, Monica Botros, Emerald Zaw, Swati Mahapatra, Jesus Guzman, Keith Garrison, Richard Mccallum
{"title":"Triple A Syndrome-A Rare Hereditary Cause of Achalasia.","authors":"Shivangini Duggal, Monica Botros, Emerald Zaw, Swati Mahapatra, Jesus Guzman, Keith Garrison, Richard Mccallum","doi":"10.14309/crj.0000000000001686","DOIUrl":"https://doi.org/10.14309/crj.0000000000001686","url":null,"abstract":"<p><p>Triple A syndrome (TAS) is a rare disorder inherited in an autosomal recessive manner. It is characterized by the triad of alacrimia, achalasia, and adrenal insufficiency. It is caused by mutations in the <i>AAAS</i> gene (achalasia-addisonianism-alacrima syndrome), which disrupts the protein ALADIN (Alacrima-Achalasia-Adrenal insufficiency Neurologic disorder protein), which plays an important role in nucleocytoplasmic transport and cellular stress response. Unlike the presented cases, most patients with TAS present in early childhood with various symptoms including dry eyes, difficulty swallowing, and recurrent infections in addition to signs of adrenal crisis such as hypotension, hypoglycemia, and hyperpigmentation. Diagnosis can be achieved by genetic testing, revealing the mutations in the <i>AAAS</i> gene. Management of TAS mainly focuses on addressing each condition separately such as prescribing artificial tears for alacrimia, glucocorticoid replacement therapy for adrenal insufficiency, and performing pneumatic dilation or surgical intervention for achalasia. Early diagnosis is crucial for improving quality of life and minimizing the morbidity and mortality linked to the syndrome.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 5","pages":"e01686"},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958627","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":"Rare Case of Tacrolimus-Induced Acute Pancreatitis in a Liver Transplant Recipient.","authors":"Renan Prado, Arjun Chatterjee, Zurabi Zaalishvili, Rupayan Kundu, Shilpa Junna, Shreya Sengupta, Nizar Zein, Syed A Mohiuddin","doi":"10.14309/crj.0000000000001659","DOIUrl":"https://doi.org/10.14309/crj.0000000000001659","url":null,"abstract":"<p><p>Tacrolimus-induced acute pancreatitis (TAP) is rare and requires thorough evaluation, including genetic testing, to rule out other causes. While TAP has been documented in a few cases following kidney transplantation, we report the first case of TAP in an adult after liver transplantation, with a noteworthy feature of late-onset TAP occurring more than 12 months after initiating tacrolimus therapy. This case highlights the potential for delayed onset of TAP, and we suggest that tacrolimus may warrant reclassification from category III to Ic in the drug-induced pancreatitis classification. In addition, we introduce sirolimus as a viable alternative for immunosuppression following TAP.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"12 5","pages":"e01659"},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959028","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}