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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Foreign body ingestion is common, although perforation after ingestion is rare. We report a case of an ingested sharp wooden stick that perforated the proximal jejunum toward the renal vasculature, causing segmental renal artery thrombosis and renal infarct. The patient presented with severe abdominal pain and vomiting. A computed tomography scan revealed a linear opacity corresponding to the foreign body. The wooden stick was removed endoscopically through deep-push enteroscopy with a rat-tooth forceps. We report this unique case of perforation by a foreign body through the proximal jejunum to the left kidney, which was managed endoscopically.
ACG Case Rep J 2017
PMID:Foreign Body Penetration through Jejunal Loops Causing Renal Artery Thrombosis and Renal Infarct. 2814 17

Herpes simplex virus (HSV) hepatitis is a rare cause of acute liver failure (ALF). It carries a mortality rate of 80% if untreated, thus early identification and treatment are critical. Without high clinical suspicion, HSV hepatitis is difficult to diagnose. A 48-year-old Hispanic female presented with a 4-day history of abdominal pain and a vaginal cuff tear requiring laparoscopic repair. She subsequently developed postsurgical disseminated HSV, resulting in ALF. Acyclovir was initiated, but she was resistant to treatment. She was given additional foscarnet and responded without requiring a liver transplant.
ACG Case Rep J 2017
PMID:Acute Liver Failure from Herpes Simplex Virus in an Immunocompetent Patient Due to Direct Inoculation of the Peritoneum. 2828 89

We present a rare case of gastrointestinal (GI) bleeding associated with metastatic prostate adenocarcinoma to the stomach. Prostate cancer, which is the most common noncutaneous malignancy among men, rarely spreads to the stomach, with only 7 cases reported in the English literature. Symptoms may include abdominal pain, nausea, vomiting, and GI bleeding. Our patient was treated with epinephrine injection and bipolar cautery, but GI bleeding recurred 7 months later when he had worsening of his thrombocytopenia while using ibuprofen.
ACG Case Rep J 2017
PMID:Gastrointestinal Bleeding from Metastatic Prostate Adenocarcinoma to the Stomach. 2837 35

A 48-year-old man with hepatitis C virus (HCV) cirrhosis complicated by hepatocellular carcinoma underwent liver transplantation. His course was complicated by fever, diarrhea, abdominal pain, and pancytopenia. He developed a diffuse erythematous rash, which progressed to erythroderma. Biopsies of the colon and skin were consistent with acute graft-versus-host disease. Donor-derived lymphocytes were present in the peripheral blood. The patient was treated with corticosteroids and cyclosporine; however, he had minimal response to intensive immunosuppressive therapy. Extracorporeal photopheresis was initiated as a salvage therapy. He had a dramatic response, and his rash, diarrhea, and pancytopenia resolved. He is maintained on minimal immunosuppression 24 months later.
ACG Case Rep J 2017
PMID:Novel Application of Extracorporeal Photopheresis as Treatment of Graft-versus-Host Disease Following Liver Transplantation. 2837 36

Fungal infections of the pancreas have been shown to occur most commonly in the setting of necrotizing pancreatitis, pancreatic cysts, or pancreatic abscesses. Pancreatic fungal infections are rare without these predisposing factors, and may present similarly to pancreatic neoplasm. We report the case of a 48-year-old man who presented with epigastric abdominal pain, nausea, vomiting, and weight loss, with a potential mass in the head of the pancreas. The mass was resected via the Whipple procedure and was found to be a fungal collection with inflammatory cells and no malignancy. The patient's clinical course improved after the resection.
ACG Case Rep J 2017
PMID:Pancreatic Fungal Ball Presenting as Pseudomass. 2845 79

Clostridium difficile infection (CDI) is a well-known complication of antibiotic therapy. It is associated with significant morbidity, mortality, and cost in the hospital setting. The main symptoms include watery diarrhea, abdominal pain, and distension, but CDI can also present as toxic megacolon, bowel perforation with peritonitis, sepsis and renal failure. Therapy includes metronidazole and oral vancomycin, with rectal vancomycin and fecal transplant reserved for more complicated cases. Adjunctive treatments such as probiotics have been tried with mixed results. We present a patient with complicated CDI treated with adjuvant serum-derived bovine immunoglobulin, a novel approach in this context.
ACG Case Rep J 2017
PMID:Serum-Derived Bovine Immunoglobulin as Novel Adjunct in Complicated Clostridium difficile Colitis Treatment. 2851 9

A 34-year-old woman with schizophrenia developed abdominal pain. Ultrasound demonstrated cholelithiasis and a dilated biliary tree. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP), sphincterotomy, and extraction of gallstones from the common bile duct. She developed post-procedure fever, tachycardia, and abdominal pain and was taken to the operating room for urgent cholecystectomy with intraoperative cholangiogram. At laparotomy, an intramural dissecting duodenal hematoma was discovered, which extended the length of the duodenum and ruptured. She underwent gastric pyloric exclusion, gastrojejunostomy, and healed uneventfully. ERCP is not without risks, and a degree of vigilance should be maintained in patients who develop new symptomatology following the procedure.
ACG Case Rep J 2017
PMID:Ruptured Dissecting Intramural Duodenal Hematoma Following Endoscopic Retrograde Cholangiopancreatography. 2858 43

Unicentric Castleman disease is a rare condition of lymphoid hyperplasia, of which only 15% of cases occur in the abdomen. We report a 66-year-old man who presented with complaints of abdominal pain. Computed tomography scans revealed nephrolithiasis and a homogeneous calcified mass between the pancreas and stomach and several para-pancreatic nodes. Direct visualization during exploratory laparotomy revealed a mass on the lesser curvature of the stomach. Pyloromyotomy and mass resection were performed. Biopsy showed reactive lymphoid hyperplasia consistent with the hyaline vascular variant of Castleman disease.
ACG Case Rep J 2017
PMID:Castleman Disease Presenting as an Abdominal Mass. 2858 44

Although rare, gastrointestinal posttransplant lymphoproliferative disorder (PTLD) can lead to abdominal pain or gastrointestinal bleeding in patients with a history of solid-organ transplantation. We describe a case of isolated gastrointestinal PTLD in a patient who presented with acute on chronic iron deficiency anemia 26 years after heart transplant. A comprehensive endoscopic evaluation with video capsule endoscopy and small bowel enteroscopy revealed a large cratered ulceration in the small bowel with abnormal mucosal changes, which led to the diagnosis of PTLD.
ACG Case Rep J 2017
PMID:Posttransplant Lymphoproliferative Disorder of the Small Bowel as an Unexpected Cause of Iron Deficiency Anemia Decades after Heart Transplantation. 2870 62

Intussusception typically occurs in infants and children, with adults representing 5% of cases. A 53-year-old African American woman presented with lower abdominal pain and tenderness. Computed tomography of the abdomen and pelvis demonstrated a 3.5 cm colocolonic intussusception in the descending colon. Emergent colonoscopy found solid stool in the mid descending colon. Water-soluble rectal enema showed a filling defect in the mid descending colon. Repeat colonoscopy demonstrated presence of a large fecaloma in left colon. Laxatives were initiated, and abdominal pain subsided. To our knowledge, this is the first report of colocolonic intussusception secondary to fecaloma.
ACG Case Rep J 2017
PMID:Transient Descending Colocolonic Intussusception Due to a Large Fecaloma in an Adult. 2879 42


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