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Case Reports in Gastroenterology

Ryota Koyama, Yoshiaki Maeda, Nozomi Minagawa, Toshiki Shinohara, Tomonori Hamada
Primary retroperitoneal mucinous cystadenoma (PRMC) is a rare cystic lesion occurring mostly in women with a histological analogy to ovarian mucinous cystadenoma. The tumor is difficult to detect during early stages because it causes symptoms only when it grows large enough to be palpable or to displace the adjacent internal organs. The primary treatment is resection, but the optimal surgical approach remains poorly known. We report the case of a 41-year-old woman who complained of right-sided intermittent abdominal pain...
January 2019: Case Reports in Gastroenterology
Ahmad Fasel Jebran, Wolfgang E Schmidt, Alisan Kahraman, Ali Canbay, Kerem Bulut
Cholangitis in patients with ulcerative colitis (UC) can lead to misdiagnosis of primary sclerosing cholangitis (PSC). Furthermore, it can mimic cholangiocellular carcinoma, which also can lead to inappropriate and potentially harmful treatment of the patient. An 18-year-old male patient with known UC presented with pain in his right upper abdomen and elevation of the cholestatic liver enzymes (alkaline phosphatase: 197 U/L, γ-glutamyltransferase: 229 U/L) and increased inflammatory parameters (leukocytosis and CrP of 13...
January 2019: Case Reports in Gastroenterology
Hiroyuki Endo, Tomoyuki Koike, Waku Hatta, Kiyotaka Asanuma, Kaname Uno, Naoki Asano, Akira Imatani, Mika Watanabe, Katsuaki Kato, Atsushi Masamune
Adenosquamous carcinoma (ASC) is a rare histological type of esophageal carcinoma. Esophagogastroduodenoscopy for the health checkup of a 71-year-old male revealed the presence of a slightly elevated lesion like a submucosal tumor at the lower part of the esophagus. The center of it was slightly depressed, and the depressed area was not stained by iodine. Magnifying endoscopy with narrow-band imaging revealed reticular pattern vessels in the depressed area, whereas no irregularity of the microvascular pattern of the surrounding area was evident...
January 2019: Case Reports in Gastroenterology
Kazuhiro Higuchi, Atsushi Nanashima, Masahide Hiyoshi, Naoya Imamura, Koichi Yano, Takeomi Hamada, Yuki Tsuchimochi, Takashi Wada, Kazuyo Tsuchiya, Fumiaki Kawano, Takuto Ikeda, Shinsuke Takeno
The indocyanine green test is a reliable liver function examination before major hepatectomy, and anaphylaxis is rarely a concern. A 65-year-old male patient without epigastralgia was diagnosed with a 2.2-cm intrahepatic cholangiocarcinoma. He had no history of allergic reactions. Some liver dysfunction was indicated by the laboratory data; however, there was no marked obstructive jaundice and the liver functional reserve was maintained by technetium-99m galactosyl serum albumin. The indocyanine green test was routinely performed, but the patient immediately demonstrated severe anaphylaxis due to indocyanine green administration...
January 2019: Case Reports in Gastroenterology
Ryota Koyama, Yoshiaki Maeda, Nozomi Minagawa, Toshiki Shinohara, Tomonori Hamada
An 89-year-old man was diagnosed with late cutaneous metastasis in the right axilla 6 years after undergoing a surgery for gastric cancer with synchronous cutaneous metastasis in the same site. The patient became aware of small reddish nodules in the right axilla, and computed tomography imaging showed an irregular thickening of the right axillary skin. No other sign of recurrence was observed. By en-bloc resection, the nodules were diagnosed as late cutaneous metastasis from gastric cancer. The patient received no additional postoperative chemo- or radiotherapy and was only carefully observed...
January 2019: Case Reports in Gastroenterology
Jiazuo H Feng, Christopher M Navas, Andrea M Olofson, Nayla Ahmed
Signet-ring cell carcinoma is a rare adenocarcinoma, predominantly affecting the stomach and ovaries. Primary sites elsewhere are rarer. It is recognized that there is an increased cancer risk with the diagnosis of Crohn's disease. We report a patient with Crohn's disease who was diagnosed with signet-ring cell carcinoma in the setting of a Crohn's flare. Diagnosis was made with endoscopy. Treatment included laparoscopic-assisted right hemicolectomy with ileostomy with subsequent chemotherapy as an outpatient...
January 2019: Case Reports in Gastroenterology
Ryota Koyama, Yoshiaki Maeda, Nozomi Minagawa, Toshiki Shinohara, Tomonori Hamada
We report the case of a 65-year-old male with a metachronous abdominal wall metastasis secondary to colorectal cancer. The patient had presented 5 years ago to another facility with a perforated sigmoid colon cancer (pT4a[SE], N0, M0, pStage II), rectal cancer (T2[MP], N0, M0, pStage I), and Fournier gangrene. He had then undergone sigmoidectomy and rectal resection along with S-1 adjuvant chemotherapy. No relapse was observed thereafter. However, currently, 5 years after initial surgery, the patient noticed a palpable mass in the left lower abdomen and was referred to our hospital for further assessment and treatment...
January 2019: Case Reports in Gastroenterology
Eric Omar Then, Rani Bijjam, Andrew Ofosu, Prashanth Rawla, Andrea Culliford, Vinaya Gaduputi
A Dieulafoy's lesion is defined as a dilated submucosal vessel that erodes the overlying epithelium without evidence of a primary ulcer or erosion. It is a rare cause of gastrointestinal bleeding that is difficult to identify and subsequently manage. Most commonly, they occur in the upper gastrointestinal tract, namely the stomach. A Dieulafoy's lesion of the rectum, however, is an exceedingly rare presentation that can lead to life-threatening gastrointestinal bleeding. Our case consists of an 84-year-old man, who presented with lower gastrointestinal bleeding secondary to a Dieulafoy's lesion of the rectum...
January 2019: Case Reports in Gastroenterology
Takashi Tashiro, Fumihiro Uwamori, Yukiomi Nakade, Tadahisa Inoue, Yuji Kobayashi, Tomohiko Ohashi, Masashi Yoneda
Gastrointestinal stromal tumors (GISTs) are known to originate specifically from the intestinal cells of Cajal located in the gastrointestinal mesenchyme. GISTs developing outside of the digestive tract have barely been reported. We encountered a first case of large primary GISTs in the liver with cystic changes. A 63-year-old man with a past history of brain infarction visited our hospital. The computed tomography (CT) revealed a 6-cm and a 10-cm mass in the right and the caudal lobe of the liver, respectively...
January 2019: Case Reports in Gastroenterology
Kenji Mimatsu, Nobutada Fukino, Hisao Kano, Atsushi Kawasaki, Takatsugu Oida
Postpancreatectomy hemorrhage is one of the major life-threatening complications of pancreatic surgery. Radiological intervention is used as a first-line approach for the initial treatment of late arterial hemorrhage. However, rehemorrhage has a high risk for mortality, and it is undecided which urgent intervention provides optimal management for rehemorrhage. We experienced a successful surgical laparotomy for the repeated delayed arterial hemorrhage caused by a pancreaticoduodenectomy (PD) for chronic pancreatitis...
January 2019: Case Reports in Gastroenterology
Bruna Rosic Despalatovic, Andre Bratanic, Zeljko Puljiz, Jasminka Bozikovic
Lichen planus is a chronic, idiopathic disorder which usually affects skin and mucosal surfaces. While oral mucosa is frequently involved, esophageal localization is uncommon, and it usually manifests with dysphagia. It has also been associated with squamous cell carcinoma. Underdiagnosing of esophageal lichen planus often leads to a delay in treatment. There are also no clear recommendations for treatment of this disorder. Systemic corticosteroids are usually the first-line therapy, but different other therapeutic approaches are also used, with a various rate of response...
January 2019: Case Reports in Gastroenterology
Winda P Bastian, Irsan Hasan, C Rinaldi A Lesmana, Ikhwan Rinaldi, Rino A Gani
Background: Dysbiosis of the gut microbiota has been considered to have a role in nonalcoholic fatty liver disease <b/> (NAFLD) progression. However, there is still lack of studies regarding this phenomenon. Aim: To find the difference in the proportion of gut microbiota in NAFLD patients based on the stages of liver fibrosis. Patients and Methods: A cross-sectional study was conducted at Dr. Cipto Mangunkusumo Hospital, which is the largest tertiary referral center...
January 2019: Case Reports in Gastroenterology
Atsunori Tsuchiya, Takeshi Suda, Chiyumi Oda, Atsushi Kimura, Kazunori Hosaka, Naruhiro Kimura, Kentaro Tominaga, Kazunao Hayashi, Masaaki Takamura, Shuji Terai
Hepatic progenitor cell (HPC) marker-positive hepatocellular carcinomas (HCCs) have recently been extensively analyzed, and their prognosis has been reported as poor compared to HPC marker-negative HCCs. However, previous studies have analyzed the existence of HPC marker-positive cancer cells only in primary lesions, as well as the recurrence rate and prognosis of such tumors. Here, we are the first to report the behavior of HPC marker-positive cancer cells during vascular invasion and metastasis of an HCC...
January 2019: Case Reports in Gastroenterology
Masashi Morimachi, Masami Ogawa, Masashi Yokota, Aya Kawanishi, Yohei Kawashima, Tetsuya Mine
A 49-year-old man was referred to our hospital for an abnormality of the hepatobiliary enzyme. The patient was diagnosed with primary sclerosing cholangitis 9 years ago, and he had a biliary stent with a string placed as an inside stent. We attempted to remove the stent 6 months later, but the string was cut off, so the stent could not be removed. Removal was attempted again, but the patient cancelled the outpatient appointments. During the examination performed at the present visit, we discovered that the biliary stent had migrated into the bile duct, and a stone had formed around the stent...
January 2019: Case Reports in Gastroenterology
Chung-Tsui Huang, Yao-Jen Liang
Nonalcoholic fatty pancreas (NAFP) is hypothetically related to progressive fibro-inflammation of the pancreas whose exocrine function is controlled by enteroendocrine cells (EEC). There is little evidence of pancreatic fibrosis in fatty pancreas and of whether there are quantitative differences for EEC. This study aimed to prove the coexistence of NAFP and pancreatic fibrosis or early chronic pancreatitis (ECP) using acoustic radiation force impulse (ARFI) and endosonography. Besides, the expression of duodenal mucosal chromogranin-A, a surrogate for EEC, was analyzed...
January 2019: Case Reports in Gastroenterology
Qiao Yu, Qiu-Yan Liu, Dan-Ming Wei, Dian-Zhong Luo
It is rare that colon carcinoma and mantle cell lymphoma (MCL) occur one after another in intestines. We found two malignancies of sigmoid carcinoma and MCL in a single patient, who had initially been diagnosed with sigmoid carcinoma and treated with radical resection in our hospital. Good postoperative recovery was reported without recurrence signs, which lasted for 7 years and 5 months until polyps of sigmoid colon were found by colonoscopy. Biopsy and immunohistochemistry revealed MCL, but the patient refused treatment...
January 2019: Case Reports in Gastroenterology
Baldeep Pabla, Douglas R Morgan
The epidemiology of peptic ulcer disease (PUD) has changed considerably in the last several decades. Previously a chronic disease characterized by frequent recurrences with a high rate of surgical interventions, it is now largely a self-limited disease that is medically managed. The role of acid suppression was widely recognized as being important in the pathogenesis of PUD in the 19th century, while it was not until the 1980s and 1990s that the importance of Helicobacter pylori infection was identified. Today, PUD is largely caused by either H...
January 2019: Case Reports in Gastroenterology
Idrees Suliman, John Guirguis, Iryna Chyshkevych, Nemer F Dabage
Colorectal cancer is a leading cause of morbidity and mortality worldwide. As such, there are recognized guidelines in the screening of this preventable cancer. There are differences in opinion regarding screening recommendations between the European and United States Cancer Prevention Societies. Screening colonoscopy is an option for routine screening for colorectal cancer in asymptomatic adults. It is a day procedure that is conducted both in hospital and specialized outpatient endoscopy suites. Serious harm is in the region of 3 per 1,000 examinations [Am J Gastroenterol...
January 2019: Case Reports in Gastroenterology
Ping-Hsiu Wu, Jui-Hao Chen, Kuang-En Chu
Endoscopic retrograde cholangiopancreatography (ERCP) is a high-risk procedure with a significantly high rate of complications, such as pancreatitis, bleeding, perforation, and infection. Pancreatitis is the most common post-ERCP complication with an incidence of approximately 3.5%. Although perforation is a rare complication with an incidence of 0.1-0.6%, it may be associated with a high rate of mortality of 1.0-1.5%. Here, we report a rare case of ERCP-induced double iatrogenic perforations in the duodenum and colon complicated by an intra-abdominal abscess...
January 2019: Case Reports in Gastroenterology
Daisuke Uehara, Hitoshi Takagi, Takashi Hoshino, Yuhei Suzuki, Satoshi Takakusagi, Kyoko Maruhashi, Kazuko Kizawa, Takashi Kosone, Atsushi Naganuma, Etsuko Hisanaga, Junko Hirato, Satoru Kakizaki, Toshio Uraoka
The patient was an 86-year-old man who was admitted with obstructive jaundice. Computed tomography revealed a tumor in the hilar choledochus with peripheral hepatic duct dilatation. Endoscopic cholangiography (ERC) demonstrated the defect in the choledochus. Brushing cytology during ERC showed Orange-G-philic keratinized atypical cells, which led to a diagnosis of squamous cell carcinoma. Chemotherapy with tegafur-gimeracil-oteracil potassium was ineffective and was discontinued due to adverse effects. The patient died 5 months after the diagnosis and autopsy revealed tubular adenocarcinoma of the hilar bile duct with squamous cell carcinoma component...
September 2018: Case Reports in Gastroenterology
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