Hiroyuki Hakoda, Yoshikuni Kawaguchi, Yoichi Miyata, Junichi Togashi, Motoki Nagai, Yoshio Suzuki, Yukihiro Nomura
INTRODUCTION: Adenosquamous carcinoma (ASC) of the ampulla of Vater (AmV) is rare. The prognosis is generally worse in patients undergoing resection of ASC of the AmV than in those undergoing resection of adenocarcinoma of the AmV because the former shows early recurrence after surgery. A treatment strategy for ASC of the AmV has not been established, and the efficacy of adjuvant chemotherapy after curative resection is unclear. Given the paucity of data, we report a case of ASC of the AmV that was curatively resected and treated with adjuvant chemotherapy...
2024: Case Reports in Gastroenterology
Chun-Chi Yang, Jui-Yi Chen, Hsuan-Yuan Chang, Ming-Jen Sheu, I-Che Feng, Su-Hung Wang, Hsing-Tao Kuo
INTRODUCTION: Syphilis, an ancient sexually transmitted disease, is recognized as a systemic infection disease manifesting with diverse symptoms and variations. Secondary syphilis characterized by systemic symptoms resulted from hematogenous and lymphatic dissemination of the infection, may include manifestations such as hepatitis and nephrotic syndrome. However, the simultaneous occurrence of hepatitis and nephrotic syndrome in secondary syphilis is rare. CASE PRESENTATION: A young man presented with fatigue, abnormal liver function tests, and hyperbilirubinemia and had history of men who have sex with men (MSM)...
2024: Case Reports in Gastroenterology
Taiyo Hirata, Shinya Kawaguchi, Taisuke Akamatsu, Atsuko Inagawa, Tomoki Hikichi, Kohei Ohkawa, Kazuhisa Asahara, Tatsunori Satoh, Shinya Endo, Makoto Suzuki, Kazuya Ohno
INTRODUCTION: Solid organ malignancies rarely metastasize to the duodenal papilla. We describe a case of primary lung cancer with duodenal papillary metastasis in a patient who presented with melena. To the best of our knowledge, this is only the second report of duodenal papillary metastasis from lung cancer. CASE PRESENTATION: A 65-year-old woman presented with complaints of anorexia, weight loss, and black stool. Imaging studies led to a clinical diagnosis of stage IVB lung cancer, and anticoagulants were initiated to treat pulmonary artery thrombosis...
2024: Case Reports in Gastroenterology
Alice S Pang, Robert Adamo, Robert Coben
INTRODUCTION: Biliopancreatic diversion with duodenal switch (BPD/DS) is an uncommon type of bariatric surgery that can rarely lead to bleeding in the biliopancreatic limb. The altered anatomy poses significant diagnostic and therapeutic challenges. CASE PRESENTATION: We present an unusual case of a woman status post-BPD/DS nearly a decade ago who presented with gastrointestinal bleeding in the duodenum of the biliopancreatic limb, a rare phenomenon given the unique surgery...
2024: Case Reports in Gastroenterology
Karen Kimura, Chikamasa Ichita, Chihiro Sumida, Takashi Nishino, Miki Nagayama, Jun Kubota, Haruto Hirose, Akiko Sasaki
INTRODUCTION: Cold snare polypectomy (CSP) is a procedure with a low risk of complications. Here, we present our experience of a rare case of submucosal abscess following CSP in an immunosuppressed patient. CASE PRESENTATION: Seventy-eight-year-old man underwent CSP, developing a fever, chills, and right lower abdominal pain 8 days later. Ultrasound and computed tomography revealed wall thickening of the ascending colon, presenting as whitening and thickening of the same region, and excretion of pus was observed after biopsy...
2024: Case Reports in Gastroenterology
Maeda Yoshiaki, Nozomi Minagawa, Takuya Kato, Naoki Okada, Takuto Suzuki, Chihiro Ishizuka, Akihisa Fukuda, Yoichi Mori
INTRODUCTION: We encountered a colon cancer case with a very rare anomaly of the middle colic artery (MCA) originating from the splenic artery (SA). CASE PRESENTATION: A woman was referred to our hospital for transverse colon cancer. Three-dimensional computed tomography (3D-CT) angiography showed an anomalous MCA originating from the SA rather than from the superior mesenteric artery (SMA) as is typical. Laparoscopic left hemicolectomy with D3 lymph node dissection was performed...
2024: Case Reports in Gastroenterology
Kimitoshi Kubo, Xinhan Zhang, Ikko Tanaka
INTRODUCTION: Precut fistulotomy is of interest as one of the salvage techniques for selective bile duct cannulation using endoscopic retrograde cholangiopancreatography. Of the various endoscopic treatments reported to date for bleeding associated with papillotomy incision, endoscopic hemostasis treatment with a novel self-assembling peptide (SAP) matrix-forming gel (TDM-621) (3-D Matrix Ltd., Tokyo, Japan) remains only insufficiently reported in the literature. CASE PRESENTATION: We herein report 6 cases of precut fistulotomy-related bleeding successfully treated with endoscopic hemostasis treatment with TDM-621, i...
2024: Case Reports in Gastroenterology
Kristína Cmarková, Lenka Nosáková, Miroslav Pindura, Martin Vojtko, Peter Bánovčin, Juraj Miklušica
INTRODUCTION: Benign lesions of the liver are very common findings, usually randomly discovered, especially during examinations for other indications. The frequent use of imaging modalities may be responsible for the statistical increase in the incidence of these findings. CASE PRESENTATION: In this publication, we present the cases of 2 female patients with benign liver lesions, the occurrence of which is considered rare, and only a few dozen cases have been described worldwide...
2024: Case Reports in Gastroenterology
Kate Hawke, Anthony Croft, Syndia Lazarus
INTRODUCTION: Hypophosphatemia occurs commonly in inflammatory bowel disease (IBD) patients and can cause considerable morbidity. The differential diagnoses in IBD include nutritional causes and hypophosphatemia induced by some formulations of intravenous iron infusions. CASE PRESENTATION: We present the case of a 37-year-old man with active Crohn's disease, presenting with difficulty walking and fractures of the vertebrae and calcaneus. He had long-standing hypophosphatemia...
2024: Case Reports in Gastroenterology
Sena Higashi, Tasuku Nakabori, Kaori Mukai, Yusuke Seiki, Ko Watsuji, Takeru Hirao, Yasuharu Kawamoto, Makiko Urabe, Yugo Kai, Ryoji Takada, Takuo Yamai, Kenji Ikezawa, Hiroyuki Uehara, Kazuyoshi Ohkawa
INTRODUCTION: Portal vein aneurysm (PVA) is a rare saccular or fusiform portal vein dilatation. The management and optimal treatment of PVA remain unknown. CASE PRESENTATION: A 53-year-old man with hepatitis C virus (HCV) infection was diagnosed with PVA measuring 28 mm in diameter. Under observation, his liver fibrosis progressed, and the PVA diameter gradually increased to 52 mm. The patient was treated with elbasvir-grazoprevir for 12 weeks, and HCV disappeared...
2024: Case Reports in Gastroenterology
Akira Ishikawa, Koki Nakamura
INTRODUCTION: Gastric adenocarcinoma with enteroblastic differentiation (GAED) is a rare histological type of gastric adenocarcinoma that occurs in the stomach and is known for its aggressive behavior. GAED is diagnosed histopathologically and is often advanced at the time of diagnosis. CASE PRESENTATION: We report the case of a 70-year-old male with a 20-mm superficial depressed lesion on the anterior wall of the antrum. Histological examination of the endoscopic submucosal dissection specimen revealed that the tumor was composed of dilated or slit-like branching tubules; additionally, the tumor cells had clear cytoplasm resembling that of the fetal digestive tract...
2024: Case Reports in Gastroenterology
Hiroyuki Ito, Yuji Omura, Tomonori Makuuchi, Tsubomi Chou, Ayano Ito, Ryutaro Fujimoto, Masashi Yokota, Shingo Tsuda, Junko Nagata, Shunji Hirose, Hisamichi Yoshii, Hideki Izumi, Tomoko Sugiyama, Takuma Tajiri, Takayoshi Suzuki
INTRODUCTION: Hemobilia, which refers to bleeding from the bile duct, is rare and difficult to treat. We report a case of successful hemostasis of a pancreatic tumor complicated by hemobilia. CASE PRESENTATION: A 76-year-old man was referred to our hospital with a pancreatic head tumor. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography-FNA were performed, and the patient was diagnosed with pancreatic metastasis of renal cell carcinoma...
2024: Case Reports in Gastroenterology
Harish Gopalakrishna, Bilal Asif, Anjali Rai, Hari S Conjeevaram, Maria Mironova, David E Kleiner, Alexandra F Freeman, Theo Heller
INTRODUCTION: Prolidase deficiency is a rare autosomal recessive disorder caused by variants in the PEPD gene. Patients usually have multi-organ involvement and a wide range of clinical features including recurrent skin ulcers, dysmorphic facial features, recurrent infections, intellectual disability, and splenomegaly. Studies have shown that patients with prolidase deficiency may have hepatic manifestations including hepatomegaly and abnormal liver enzymes. However, there is no detailed description of liver disease in this patient population...
2024: Case Reports in Gastroenterology
Asuka Watanabe, Tsutomu Nishida, Naoto Osugi, Takao Kitanaka, Yutaro Minoura, Satoru Okabe, Naohiro Sakamoto, Yoshifumi Fujii, Aya Sugimoto, Dai Nakamatsu, Kengo Matsumoto, Masashi Yamamoto, Shiro Adachi, Koji Fukui
INTRODUCTION: Drug-induced liver injury (DILI) associated with 5-aminosalicylic acid (5-ASA) is a rare but potentially life-threatening adverse event. CASE PRESENTATION: We report the case of a 58-year-old woman with ulcerative colitis who developed DILI after initiating maintenance therapy with the multimatrix system 5-ASA. The patient presented with grade 4 liver enzyme elevation on day 98 after initiating 5-ASA and was admitted to the hospital. Blood tests revealed the mixed liver injury, and imaging studies showed no abnormalities except for mild lymph node enlargement...
2024: Case Reports in Gastroenterology
Kaoru Abe, Daisuke Yamai, Chihiro Katsumi, Manabu Oyamatsu, Kenji Sato
INTRODUCTION: A stoma prolapse is easy to diagnose by visual examination, and it rarely incarcerates. Therefore, manual reduction is usually performed as soon as the diagnosis is made. In this report, we describe a case of stoma prolapse that could not be reduced manually and ruptured because an incarcerated parastomal hernia occurred in the stoma, mimicking stoma prolapse. CASE PRESENTATION: A 66-year-old woman underwent total hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, omentectomy, resection of dissemination, and low anterior resection with formation of a sigmoid end colostomy for endometrial cancer with infiltration of the rectum...
2024: Case Reports in Gastroenterology
Kinga Szopińska, Karolina Tracz, Żaneta Malczyk, Anna Jarzumbek, Andrzej Grabowski, Katarzyna Bąk-Drabik
INTRODUCTION: Bezoars are masses of indigestible foreign material in the gastrointestinal tract, usually in the stomach. These materials could be indigestible fruits, hair, milk products, or tablets. In children, the most common type of bezoar is trichobezoar (formed from hair). CASE PRESENTATION: We describe a female patient who has been complaining about deterioration of mood, collapse without losing consciousness, scotomas, and cardiac arrhythmia for 2 years...
2024: Case Reports in Gastroenterology
Simone A Jarrett, Sahana Tito, Matthew Chan, Dominic E Jarrett, Kevin B Lo, Richard DePalma
INTRODUCTION: The purpose of this case series was to review a rare subset of tumors known as gastric lipomas, which are typically found incidentally. The motivation for this study arose from the identification of 2 cases within our institution in a short period. CASE PRESENTATION: The study involved a review of the diagnosis and management of 2 patients presenting with gastric lipomas at our institution after symptoms of gastrointestinal bleeding. With the advent of new radiologic investigations such as computed tomography and magnetic resonance imaging and advances in endoscopy, there are new approaches to identifying and managing these tumors...
2024: Case Reports in Gastroenterology
Hiroki Kawanaka, Kazuto Tajiri, Nozomu Muraishi, Aiko Murayama, Takamasa Nukui, Ichiro Yasuda
INTRODUCTION: Immune checkpoint inhibitors are sometimes associated with immune-related adverse events during or after treatment. Among these, aseptic meningitis is a rare and serious complication. We report the first case of atezolizumab-induced aseptic meningitis, which occurred during treatment for advanced hepatocellular carcinoma (HCC). CASE PRESENTATION: A 74-year-old woman diagnosed with advanced HCC and treated with first-line atezolizumab plus bevacizumab developed anorexia, fatigue, and fever, after three treatment cycles...
2024: Case Reports in Gastroenterology
Nishigandha Burute, Olexiy Aseyev, Fauzia Hasan, Erika Allard-Ihala, Walid Shahrour, Ahmed Kotb, William Harris, Radu Rozenberg
INTRODUCTION: Primary appendiceal carcinoma is rare and comprises up to 1% of all colorectal malignancies. Its invasion into adjacent organs, such as the bladder and rectum, especially as a presenting characteristic, is even less common. CASE PRESENTATION: A 75-year-old asymptomatic male tested positive on a screening fecal immunochemical test (FIT). Colonoscopy showed a rectosigmoid tumor and normal appendiceal orifice. Staging MRI surprisingly showed that the cancer was, in fact, of appendiceal origin, coursed posteriorly to invade the rectosigmoid and form adhesions with the urinary bladder...
2024: Case Reports in Gastroenterology
Brian Nohomovich, Minh H N Nguyen, Joseph Fakhoury, Russell C Cameron, Theotonius Gomes
INTRODUCTION: Down syndrome is due to trisomy 21 and is characterized by intellectual disability, dysmorphic facial features, congenital malformations, and gastrointestinal abnormalities. There is an increased appreciation of congenital portosystemic shunts in Down syndrome patients. Congenital portosystemic shunts have been associated with many defects in body systems, including cardiac, metabolic, and neurological. CASE PRESENTATION: Herein, we describe a portosystemic shunt in a Down syndrome patient that resulted in hyperammonemia with altered mental status and choreiform movements...
2023: Case Reports in Gastroenterology
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