Case Reports in Gastroenterology最新文献_第3页

Erratum. 勘误。

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Case Reports in Gastroenterology Pub Date : 2024-08-30 eCollection Date: 2024-01-01 DOI: 10.1159/000540535

引用次数: 0

Endoluminal Vacuum Therapy for the Management of Boerhaave Syndrome: A Case Series. 用于治疗波尔哈韦综合征的腔内真空疗法：病例系列。

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Case Reports in Gastroenterology Pub Date : 2024-08-28 eCollection Date: 2024-01-01 DOI: 10.1159/000540694

Daniella Soussi, Batool Helmi Ahmad Alharahsheh, Piers Robert Boshier, Jonathan Hoare, Natalie Direkze, Robert Thomas, Christopher John Peters, Sophie Stevens

{"title":"Endoluminal Vacuum Therapy for the Management of Boerhaave Syndrome: A Case Series.","authors":"Daniella Soussi, Batool Helmi Ahmad Alharahsheh, Piers Robert Boshier, Jonathan Hoare, Natalie Direkze, Robert Thomas, Christopher John Peters, Sophie Stevens","doi":"10.1159/000540694","DOIUrl":"https://doi.org/10.1159/000540694","url":null,"abstract":"Introduction: Boerhaave syndrome is a rare condition associated with high morbidity and mortality. Prompt intervention greatly improves outcomes, with surgery traditionally being the mainstay of management. Recent advances in therapeutic endoscopy have led to increasing interest in endoluminal vacuum therapy (EVT), a minimally invasive technique, allowing wound debridement and drainage, encouraging granulation tissue formation. EVT has been associated with positive clinical outcomes, including lower mortality rates compared to surgery and stenting for the management of anastomotic leaks, and to a lesser extent, oesophageal perforations. EVT has been adopted into practice across Europe; however, only few cases have been reported from the UK.Case presentations: We report three cases of Boerhaave syndrome, successfully managed with EVT, using the Eso-SPONGE ® (B.Braun Medical Ltd, Sheffield, UK). EVT involves the placement of a polyurethane sponge into the wound cavity. The cavity is initially assessed, then an overtube is introduced through which the sponge is inserted, and then the overtube is removed. Sponge position is confirmed and adjusted if necessary. The sponge is connected via a trans-nasal drain to continuous negative pressure suction and is changed every 3-5 days. Having been deemed surgically unfit, all 3 patients were referred for EVT. All patients made excellent recovery and were discharged home.Conclusion: EVT is an effective management strategy for surgically unfit Boerhaave syndrome patients. Eso-SPONGE use aided drainage of the septic focus and closure of the defect, leading to complete recovery. Our findings support the existing evidence that EVT is a promising solution for Boerhaave syndrome.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"18 1","pages":"402-411"},"PeriodicalIF":0.5,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543903","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 Tuberculosis as a Rare Cause of Dysphagia: Case Report. 食道结核是吞咽困难的罕见病因：病例报告。

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Case Reports in Gastroenterology Pub Date : 2024-08-01 eCollection Date: 2024-01-01 DOI: 10.1159/000540292

Billy Zhao, Hyun Jae Kim, Jessica Farrell, Wei Xiong, Jennifer Telford, Sarvee Moosavi

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Case Study of a Refractory Idiopathic Peptic Ulcer in Which 24-h Intragastric pH Monitoring Contributed to Its Pathophysiological Analysis. 难治性特发性消化性溃疡病例研究，其中 24 小时胃内 pH 值监测有助于病理生理学分析。

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Case Reports in Gastroenterology Pub Date : 2024-07-31 eCollection Date: 2024-01-01 DOI: 10.1159/000540185

Tomoyo Iwano, Tsutomu Takeda, Shotaro Oki, Yasuko Uemura, Momoko Yamamoto, Ryota Uchida, Hisanori Utsunomiya, Daiki Abe, Nobuyuki Suzuki, Atsushi Ikeda, Yoichi Akazawa, Kumiko Ueda, Hiroya Ueyama, Mariko Hojo, Akihito Nagahara

{"title":"Case Study of a Refractory Idiopathic Peptic Ulcer in Which 24-h Intragastric pH Monitoring Contributed to Its Pathophysiological Analysis.","authors":"Tomoyo Iwano, Tsutomu Takeda, Shotaro Oki, Yasuko Uemura, Momoko Yamamoto, Ryota Uchida, Hisanori Utsunomiya, Daiki Abe, Nobuyuki Suzuki, Atsushi Ikeda, Yoichi Akazawa, Kumiko Ueda, Hiroya Ueyama, Mariko Hojo, Akihito Nagahara","doi":"10.1159/000540185","DOIUrl":"10.1159/000540185","url":null,"abstract":"Introduction: In recent years, the frequency of idiopathic peptic ulcers (IPUs) has increased. However, the clinicopathological characteristics of IPU have not been fully elucidated and treatment methods for recurrent and refractory cases have not yet been established.Case presentation: A man in his forties complained of epigastric discomfort. Esophagogastroduodenoscopy revealed a gastric ulcer in the lesser curvature of the gastric angle. After Helicobacter pylori was eradicated, the gastric ulcer recurred despite the administration of a potassium competitive acid blocker (PCAB), and a diagnosis of IPU was made. Twenty-four-hour intragastric pH monitoring revealed insufficient gastric acid suppression. Misoprostol was added to the patient's treatment. Subsequently, the ulcer healed and recurrence was not observed.Conclusion: For refractory IPU, the evaluation of pathophysiological function through 24-h gastric pH monitoring may lead to the selection of an appropriate treatment. If a proton pump inhibitor and PCAB do not improve the IPU, combination treatment with misoprostol may be considered as an option.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"18 1","pages":"386-394"},"PeriodicalIF":0.5,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981730","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

Tuberculosis of the Stomach Mimicking Gastric Submucosal Tumor: Diagnosis by Endoscopic Ultrasound. 模仿胃粘膜下肿瘤的胃结核：通过内窥镜超声诊断。

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Case Reports in Gastroenterology Pub Date : 2024-07-30 eCollection Date: 2024-01-01 DOI: 10.1159/000540293

Hasan Maulahela, Nagita Gianty Annisa, Ari Fahrial Syam, Marini Stephanie, Yayi Dwina Billianti

{"title":"Tuberculosis of the Stomach Mimicking Gastric Submucosal Tumor: Diagnosis by Endoscopic Ultrasound.","authors":"Hasan Maulahela, Nagita Gianty Annisa, Ari Fahrial Syam, Marini Stephanie, Yayi Dwina Billianti","doi":"10.1159/000540293","DOIUrl":"10.1159/000540293","url":null,"abstract":"Introduction: Gastrointestinal tuberculosis (TB), specifically gastric TB, is a rare form of extrapulmonary TB. Diagnosis proves challenging with nonspecific signs and symptoms. In this case report, a 22-year-old male came in with complaints of recurrent hematemesis and melena.Case presentation: We found a submucosal mass with ulceration in the stomach cardia on esophagoduodenoscopy (EGD). The endoscopic ultrasound (EUS) finding was a hypoechoic submucosal lesion with a clear margin; specimens were taken using fine needle aspiration (FNA) for further histopathological examination. The result indicated granuloma of Mycobacterium Tuberculosis in pathology, suggesting that the diagnosis was gastric TB. The patient was then treated with antitubercular therapy regimen for 9 months. The previously documented mass in the stomach cardia was no longer visible on the follow-up endoscopy examination, and the patient was considered cured.Conclusion: This case shows that gastric tuberculosis should be considered in patients with gastrointestinal symptoms, especially those living in TB endemic regions. Endoscopic examinations, such as EGD and EUS, may aid in the diagnosis of gastric tuberculosis.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"18 1","pages":"379-385"},"PeriodicalIF":0.5,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981735","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

Small Bowel Bleeding Caused by a Small Bowel Lipoma in a Patient with Hemodialysis. 血液透析患者小肠脂肪瘤引发的小肠出血。

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Case Reports in Gastroenterology Pub Date : 2024-07-25 eCollection Date: 2024-01-01 DOI: 10.1159/000540074

Shunsuke Yamagishi, Woodae Kang, Masataka Shindate, Yoritaka Matsuno, Masahiro Yoshida, Mitsugu Kochi

{"title":"Small Bowel Bleeding Caused by a Small Bowel Lipoma in a Patient with Hemodialysis.","authors":"Shunsuke Yamagishi, Woodae Kang, Masataka Shindate, Yoritaka Matsuno, Masahiro Yoshida, Mitsugu Kochi","doi":"10.1159/000540074","DOIUrl":"10.1159/000540074","url":null,"abstract":"Introduction: Small bowel bleeding is being diagnosed with increasing frequency with the development of capsule endoscopy.Case presentation: We report a case of lipoma that caused hematochezia in an 80-year-old woman with ischemic heart disease receiving antiplatelet therapy and on hemodialysis for renal failure. Contrast-enhanced computed tomography scans, esophagogastroduodenoscopy, and colonoscopy failed to identify the source of hematochezia. Capsule endoscopy revealed a small bowel tumor, which was removed through laparoscopic surgery without interruption of antiplatelet agents. The small bowel tumor was pathologically diagnosed as a lipoma. There was no recurrence of the hematochezia after surgery.Conclusion: Lipomas could cause hematochezia. With appropriate preoperative testing, comorbidity assessment, and surgical planning, we believe that surgical resection is a safe treatment option for the removal of small bowel lipomas even in patients who are on hemodialysis or are taking antiplatelet agents.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"18 1","pages":"373-378"},"PeriodicalIF":0.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981734","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

Finding the Balance: Venous Thromboembolism Prophylaxis during Hematochezia in Crohn's Disease. 寻找平衡：克罗恩病患者血崩期间的静脉血栓栓塞预防。

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Case Reports in Gastroenterology Pub Date : 2024-07-22 eCollection Date: 2024-01-01 DOI: 10.1159/000540128

Kain Kim, Danielle Llanos, Christopher Ramos, Nikrad Shahnavaz, Bhavin B Adhyaru

{"title":"Finding the Balance: Venous Thromboembolism Prophylaxis during Hematochezia in Crohn's Disease.","authors":"Kain Kim, Danielle Llanos, Christopher Ramos, Nikrad Shahnavaz, Bhavin B Adhyaru","doi":"10.1159/000540128","DOIUrl":"10.1159/000540128","url":null,"abstract":"Introduction: Despite heightened risk of venous thromboembolism (VTE) in hospitalized patients with inflammatory bowel disease (IBD), pharmacologic prophylaxis remains underutilized, particularly in those presenting with hematochezia. Although placement of retrievable inferior vena cava filters (rIVCF) may be considered in those with contraindications to anticoagulation and VTE risk, current recommendations from clinical guidelines are incongruent, leading to wide variation in practice.Case presentation: This report highlights a case of rIVCF used in the management of recurrent VTEs in a patient hospitalized for persistent gastrointestinal bleeding.Conclusion: Our case demonstrates the need for a lower threshold for initiating VTE prophylaxis in patients with active IBD, even when hematochezia is the presenting symptom. A small group of patients with recurrent VTE and clear contraindications to anticoagulation may require IVCFs, necessitating close follow-up and monitoring for filter complications.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"18 1","pages":"367-372"},"PeriodicalIF":0.5,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981732","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

Non-Cirrhotic Portal Hypertension in Turner's Syndrome: A Case Report. 特纳综合征非肝硬化门脉高压症：病例报告。

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Case Reports in Gastroenterology Pub Date : 2024-07-22 eCollection Date: 2024-01-01 DOI: 10.1159/000539500

Arsia Jamali, Adewale Ajumobi

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Clearance of Hepatitis C Virus following Immune Checkpoint Inhibitor Therapy for Hepatocellular Carcinoma: Case Report. 免疫检查点抑制剂治疗肝细胞癌后清除丙型肝炎病毒：病例报告。

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Case Reports in Gastroenterology Pub Date : 2024-06-27 eCollection Date: 2024-01-01 DOI: 10.1159/000539646

Harry Wilson, Douglas Macdonald, Kathleen Bryce

{"title":"Clearance of Hepatitis C Virus following Immune Checkpoint Inhibitor Therapy for Hepatocellular Carcinoma: Case Report.","authors":"Harry Wilson, Douglas Macdonald, Kathleen Bryce","doi":"10.1159/000539646","DOIUrl":"10.1159/000539646","url":null,"abstract":"Introduction: Patients with advanced hepatocellular carcinoma (HCC) have limited treatment options in the context of decompensated cirrhosis. HCC occurs in patients with hepatitis C virus (HCV) infection and cirrhosis at 1-4% per year. Direct-acting antiviral (DAA) efficacy is decreased in the presence of HCC. We present a case where immunotherapy may have resulted in HCV clearance, when DAA therapy had been ineffective. We hypothesise that immune checkpoint inhibitors targeting the PD-1/PD-L1 pathway can reverse T-cell exhaustion and aid in the clearance of chronic HCV.Case presentation: This case study describes a male in his 40 s identified by a re-engagement initiative for HCV, who had been unaware of his diagnosis. On further investigation he was found to have compensated for liver cirrhosis and HCC. He was treated with HCV DAA therapy (sofosbuvir/velpatasvir) and then systemic immunotherapy for HCC with atezolizumab and bevacizumab, in an attempt to downstage the disease. Hepatitis C therapy did not achieve sustained virological response, with viral relapse after the end of treatment. This, combined with ongoing alcohol use, resulted in hepatic decompensation and cessation of immunotherapy after the fifth cycle. The HCV RNA subsequently became undetectable without further DAA re-treatment.Conclusion: To our knowledge, this is the first case of HCV clearance after DAA relapse and the timing of this event after immunotherapy suggests a causal link. We hypothesise that this may be due to the reversal of antiviral T-cell exhaustion. This would therefore support further investigation into other chronic viral infections that create tumour associated with immunosuppressive microenvironments.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"18 1","pages":"347-351"},"PeriodicalIF":0.5,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626097","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

Severe Bradycardia Associated with the Use of Terlipressin: A Case Report. 与使用特利加压素有关的严重心动过缓：病例报告。

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Case Reports in Gastroenterology Pub Date : 2024-06-20 eCollection Date: 2024-01-01 DOI: 10.1159/000539439

Alex Yartsev, Jessica T Nguyen

{"title":"Severe Bradycardia Associated with the Use of Terlipressin: A Case Report.","authors":"Alex Yartsev, Jessica T Nguyen","doi":"10.1159/000539439","DOIUrl":"10.1159/000539439","url":null,"abstract":"Introduction: Although terlipressin is known to cause bradycardia, this adverse effect is usually described in association with hypertension and is considered a benign compensatory response mediated by arterial baroreceptors. Cardiac monitoring for patients receiving terlipressin is not routinely recommended.Case presentation: A 77-year-old female patient with no history of coronary artery disease and no other coexisting risk factors for cardiac arrhythmias or conduction disturbances was admitted to intensive care unit with severe cholangitis, complicated by variceal bleeding. She developed severe sinus bradycardia following the use of terlipressin, which was associated with significant hypotension that required the infusion of norepinephrine. The bradycardia occurred again when terlipressin therapy was reattempted.Conclusion: Vasopressin is known to sensitize baroreceptor reflexes by a central mechanism though its actions on V1a receptors in the area postrema, and we speculate that vasopressin analogues such as terlipressin may act in the same manner. That this effect is not widely described in terlipressin safety literature may be due to the overall younger age range of the trial population. This raises the possibility that cardiac monitoring may be warranted for elderly patients receiving terlipressin.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"18 1","pages":"340-346"},"PeriodicalIF":0.5,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629690","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