Journals Case Reports in Gastrointestin...

Case Reports in Gastrointestinal Medicine
Dorinda Mullen, Rajkumar Vajpeyi, Jose-Mario Capo-Chichi, Klaudia Nowak, Newton Wong, Runjan Chetty
Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the GI tract, usually found in the stomach, jejunum, and ileum. Typically, they are KIT or PDGFR -mutated, allowing for targetable treatments with tyrosine kinase inhibitors such as imatinib. Here, we present two KRAS -mutated wild-type gastrointestinal tumours (GISTs). Both cases occurred in the small bowel of females. Immunohistochemical studies on both tumours showed KIT and DOG-1 positivity, with SDHB retained. Molecular analysis revealed a KRAS G12D mutation and a KRAS G13D mutation, respectively...
2023: Case Reports in Gastrointestinal Medicine
Kevin Yang, Nariman Hossein-Javaheri, Naren Nallapeta, Mayada Ismail
Perigastric and intramural gastric hematomas rarely occur, with most cases associated with trauma, coagulopathy, and peptic ulcer disease. Furthermore, hematomas in the upper gastrointestinal tract are commonly located in the esophagus and duodenum. In this case report, we describe a hematoma masquerading as a gastric tumor on esophagogastroduodenoscopy (EGD) in a 54-year-old male presenting with melena. Initial computed tomography (CT) imaging suggested gastrointestinal stromal tumor (GIST) as the probable cause...
2023: Case Reports in Gastrointestinal Medicine
Hannah Saven, Ashton Harmacinski, Andrew Canakis, Uni Wong
Entamoeba histolytica is a parasite that typically causes amoebic dysentery but can result in complications such as pyogenic liver abscess. Patients with inflammatory bowel disease often take immunosuppressive therapies that make them more susceptible to such infections. Notably, parasitic infections in this context are rare in nonendemic areas. We describe a 57-year-old man who recently started infliximab therapy for Crohn's disease and presented with fever and right upper quadrant pain. While hospitalized, this patient was diagnosed with Entamoeba histolytica liver abscess...
2023: Case Reports in Gastrointestinal Medicine
Yoshitsugu Misumi, Kouichi Nonaka, Maiko Kishino
PuraStat® (3D Matrix, Tokyo, Japan) is a novel, self-assembling peptide hemostatic hydrogel that can be used endoscopically. Hemostasis can be physically obtained by covering bleeding points; however, there are no reports of how long PuraStat remains in the upper gastrointestinal tract. Herein, we report a case wherein esophagogastroduodenoscopy (EGD) was performed 2 hours after PuraStat application. A 73-year-old man underwent EGD for evaluation of lesions in the posterior wall of the stomach. A biopsy was then performed on the gastric lesions; however, massive bleeding occurred...
2023: Case Reports in Gastrointestinal Medicine
Sobaan Taj, Chris Austin, Azhar Hussain, Maryam Salma Babar, Harshavardhan Sanekommu, Steven Imburgio, Anmol Johal, Alejandro CruzPonce, Apurva Vedire, Edward Liu
Monkeypox is primarily a painful cutaneous disease with occasional systemic manifestations. Monkeypox is transmitted predominantly through close physical contact and occasionally sexual contact. The first case was reported in the United States on May 17, 2022, in a recent monkeypox worldwide outbreak. We present a case of severe gastrointestinal bleeding as an atypical manifestation of monkeypox infection in a 40-year-old male with HIV. In our case, monkeypox-induced proctocolitis progressed to severe rectal bleeding requiring one unit of packed red blood cells transfusion despite one week of tecovirimat (TPOXX) therapy...
2023: Case Reports in Gastrointestinal Medicine
Mohammed Rifat Shaik, Chet Ranabhat, Nishat Anjum Shaik, Akshay Duddu, Zaid Bilgrami, Guofeng Xie
Gastric pneumatosis, an uncommon radiologic finding characterized by the presence of gas within the gastric wall, presents a diagnostic challenge due to its association with both benign gastric emphysema and more severe emphysematous gastritis. The contrasting outcomes and management approaches for these conditions underscore the necessity for accurate diagnosis and appropriate intervention. We present a case of a 29-year-old female with a medical history significant for type 1 diabetes mellitus who presented with abdominal pain, nausea, and vomiting...
2023: Case Reports in Gastrointestinal Medicine
Sophia Dar, Nooraldin Merza, Maryam Haider, Yousaf Zafar, Noren Din, Rosario Ligresti, Rani Sebti
Stenotrophomonas maltophilia (SM) is a multidrug-resistant, Gram-negative (GN) bacillus that is an increasingly recognized nosocomial and environment pathogen. It is intrinsically resistant to carbapenems, a drug commonly utilized in the management of necrotizing pancreatitis (NP). We report a 21-year-old immunocompetent female with NP complicated by pancreatic fluid collection (PFC) infected with SM. One-third of patients with NP will develop infections by GN bacteria, while broad-spectrum antibiotics, including carbapenems, cover most infections, trimethoprim-sulfamethoxazole (TMP-SMX) is the first-line treatment antibiotic for SM...
2023: Case Reports in Gastrointestinal Medicine
Abdulrahman Qatomah, Sulaiman Almushir, Faisal Aljohani
Ectopic varices account for 1%-5% of all variceal bleeding episodes in patients with portal hypertension. They can be found at any part of gastrointestinal tract including the small intestines, colon, or rectum. We report a case of a 59-year-old man who presented with bleeding per rectum 2 days after a routine colonoscopy, in which 2 lesions were biopsied. Gastroscopy was negative for bleeding, and he was not stable enough to undergo colonoscopy. CT angiography showed a large portosystemic shunt with multiple collaterals in the right lower quadrant...
2023: Case Reports in Gastrointestinal Medicine
Anas Khouri, Cesar Moreno, Benjamin Niland
Patients with autoimmune conditions show a high expression of proinflammatory cytokines including interleukin (IL)-17. While IL-17 inhibitors have demonstrated efficacy in managing autoimmune disorders, rare instances of de novo or exacerbated inflammatory bowel disease (IBD) have been reported. The factors that affect the onset and severity remain unclear. Here, we present a case of a 38-year-old female who developed manifestations of Crohn's disease within 1 month of initiating secukinumab treatment for psoriatic arthritis, in addition to a review of the role of IL-17 in the pathophysiology of Crohn's disease...
2023: Case Reports in Gastrointestinal Medicine
Sucong Lyu, Guoqiang Zhong, Hui Chen, Jin Li, Mingsong Li
The cribriform-morular variant of papillary thyroid carcinoma (CMV-PTC) is now designated as morular cribriform thyroid carcinoma (CMTC) according to the 5th edition of the World Health Organization (WHO) Classification of Thyroid Tumors. CMTC can appear within a familial adenomatous polyposis (FAP) or be sporadic. We report the first case of a young female patient in China who was diagnosed with FAP and CMTC with a mutation in exon 16 of the APC gene underlying the disease. The main purpose of this case report is to provide a special pathological type of thyroid tumors, which is expected to be helpful for clinical work in the future...
2023: Case Reports in Gastrointestinal Medicine
Seo Hyun Kim, Youssef Soliman, Vikas N Chitnavis, Maithili V Chitnavis
Mucosa-associated lymphoid tissue (MALT) lymphoma is a common cause of gastric lymphoma. Although most cases are associated with an H. pylori infection, approximately 10% are H. pylori -negative. Patients with gastric MALT lymphoma are usually asymptomatic or present with nonspecific symptoms such as abdominal pain, dyspepsia, weight loss, and occult gastrointestinal bleeding. In this report, we describe two patients with H. pylori -negative MALT lymphoma who both presented with acute upper gastrointestinal bleeding that led to hemodynamic instability...
2023: Case Reports in Gastrointestinal Medicine
Janine Beatrice Borja, Ghanshyam Patel, Luqman Baloch, Ammar Aqeel, Mool Chand, Hariprasad Korsapati, Altaf Dawood, Naser Khan
Acquired tracheoesophageal fistula (TEF) is a rare complication of esophageal or lung cancer. A 57-year-old male presented with complaints of vomiting, cough, 20 lb weight loss, and progressive dysphagia. Early laryngoscopy and CT chest showed a normal pharynx with an irregular thickness of the thoracic esophagus. The upper gastrointestinal endoscopy (UGIE) and upper endoscopic ultrasound (EUS) revealed a hypoechoic mass evolving as complete obstruction. During the procedure, minimal CO2 was used for insufflation; however, when attempts were made to traverse the obstruction, capnography revealed an end-tidal CO2 (EtCO2 ) estimating 90 mmHg indicating possible TEF...
2023: Case Reports in Gastrointestinal Medicine
Kevin Groudan, Tiago Martins, Ira J Schmelkin
Anisakiasis of the gastrointestinal tract is caused by the consumption of raw or undercooked seafood infected with Anisakis larvae. Penetration of Anisakis larvae into the gastrointestinal mucosa leads to severe epigastric pain, nausea, and vomiting, usually within hours of ingestion of the parasite. Suspicion for gastrointestinal Anisakiasis should be raised in patients with a compatible dietary history. Definitive diagnosis can be made by direct visualization of larvae via endoscopic examination. Although symptoms are self-limiting, the removal of larvae by gastroscopy can hasten relief of symptoms...
2023: Case Reports in Gastrointestinal Medicine
Mark G Evans, Jack P Guccione, Anthony Crymes, Xiaodong Li, Cary A Johnson, Vishal S Chandan, Yuxin Lu
Collagenous gastritis has been reported as a rare cause of nausea, diarrhea, weight changes, and early satiety in female patients. Here, we describe two women aged 43 and 71 years who presented with similar symptoms. Gastric biopsies from both individuals showed thickened, irregular subepithelial collagen bands (>10  μ m). The pathogenesis of collagenous gastritis is poorly understood, but it may be the presenting symptom for many underlying autoimmune conditions. In particular, there is a well-established connection between collagenous disorders of the gastrointestinal tract and celiac sprue, Sjögren syndrome, and lymphocytic colitis; however, none of these conditions had been diagnosed in our patients...
2023: Case Reports in Gastrointestinal Medicine
Aida Nasirishargh, Bao Sean Huy Nguyen, Michael J Lawson, Eric J Mao
Esophago-respiratory fistula (ERF) refers to the formation of a pathological connection between the esophagus and respiratory tract. Acquired ERF is a rare but life-threatening diagnosis in adults. We describe a 79-year-old male who was admitted with an inhalation smoke injury. He was diagnosed with ERF by endoscopic visualization and sampling of the hyaline cartilage within the wall of the esophagus. Percutaneous endoscopic gastrostomy placement and conservative measures were effective in the management of ERF...
2023: Case Reports in Gastrointestinal Medicine
Clive Jude Miranda, Murad Hayatt Ali, Muddasir Ayaz, Yousef Soofi, Thomas Christopher Mahl
Whereas typical Crohn's disease is confined to the terminal ileum and presents with abdominal pain and diarrhea, gastroduodenal manifestations of Crohn's disease are rare, with often asymptomatic patient presentations and inconclusive diagnostic testing. It is, however, a more severe form of Crohn's disease and thus warrants treatment with steroids and biologics much earlier than its ileocolonic counterpart. We present the case of a young, otherwise healthy, male with newly diagnosed ileocolonic Crohn's disease with concurrent gastroduodenal involvement that initially failed management with biologic agents...
2022: Case Reports in Gastrointestinal Medicine
Masaya Iwamuro, Takehiro Tanaka, Akifumi Matsumura, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada
A 65-year-old Japanese woman underwent umbilical cord blood transplantation for acute myeloid leukemia. Zinc acetate dihydrate tablets were administered for hypozincemia after transplantation, and vomiting and appetite loss occurred soon thereafter. Esophagogastroduodenoscopy revealed mucosal redness, erosion, white coat adhesion, and ulcers. Although graft-versus-host disease, intestinal transplant-associated microangiopathy, and cytomegalovirus infection were considered as possible causes, we diagnosed the patient with zinc acetate dihydrate tablet-associated gastric mucosal alterations based on the endoscopic features...
2022: Case Reports in Gastrointestinal Medicine
Mohammad Nabil Rayad, Noreen Mirza, Maria Bernardeth Herrera-Gonzalez, Yatinder Bains, Sarahi Herrera-Gonzalez
McKittrick-Wheelock syndrome commonly presents with a triad of chronic secretory diarrhea, electrolyte disturbances, and renal failure. Secretory diarrhea is due to active ion secretion secondary to secretagogue secretion (cyclic adenosine monophosphate and prostaglandin E2). The mainstay of treatment for these lesions is surgical since it will arrest the loss of electrolytes that may lead to serious clinical consequences. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as indomethacin may be used to decrease electrolyte secretion in patients that desire a nonsurgical approach...
2022: Case Reports in Gastrointestinal Medicine
Margaret R Paulson, Abdullah S Eldaly, Francisco R Avila, Ricardo A Torres-Guzman, Karla C Maita, John P Garcia, Luiza Palmieri Serrano, Omar S Emam, Antonio J Forte, Michael J Maniaci
In 2020, Mayo Clinic established an Advanced Care at Home (ACH) program. ACH is a virtual hybrid hospital-at-home (HaH) program that combines telemedicine with in-home care services by utilizing a state that is software-driven, vendor-mediate medical supply chain. The program initially focused on acute medical diagnosis but has expanded to oversee surgical and postsurgical patients with continued inpatient needs. Here, we report the first case of a small bowel obstruction (SBO) managed under a HaH program. A 52-year-old lady presented to the emergency department with symptoms suggestive of mechanical SBO...
2022: Case Reports in Gastrointestinal Medicine
Jeffrey K Than, Greg S Cohen
Colovesical fistula is an infrequent complication of diverticular disease that presents with pneumaturia, fecaluria, dysuria and, rarely, hematuria or hematochezia. Here we present a case of concurrent hematuria and rectal bleeding arising from a diverticular bleed traversing a previously undiagnosed colovesical fistula. Other causes of colovesical fistula include Crohn's disease, radiation, and malignancy, though it is most commonly caused by complicated diverticulitis as in this case. Computed tomography (CT) imaging, cystoscopy, and gastrograffin enema have been described as high-yield diagnostic tests...
2022: Case Reports in Gastrointestinal Medicine
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