Medical Reports最新文献

Background

Case report

Conclusion

Neuroendocrine tumors (NETs) correspond to a wide group of neoplasms that can arise from various parts of the body, with rectal NETs often being discovered incidentally during colonoscopies. This case report describes a 41-year-old female with a rectal NET identified during routine screening, displaying a distinct “tree-on-sunset” appearance on narrow-band imaging (NBI). The mass, confirmed as a well-differentiated grade 2 NET via endoscopic ultrasound (EUS) and biopsy, was resected using endoscopic mucosal resection (EMR). This report underscores the importance of advanced imaging techniques, such as NBI, in enhancing the accuracy of rectal NET diagnosis and encourages further studies to validate the diagnostic significance of such imaging features.

Complementary and alternative medicine approaches are widely used by breast cancer patients. We present a case series of four patients with breast cancer who underwent a pragmatic integrative medicine protocol in an inpatient integrative oncology setting. The participants were three metastatic and one non-metastatic breast cancer patient who did not undergo any standard cancer therapies. The holistic integrative medicine protocol includes counselling, oncothermia, high-dose vitamin C therapy, ozone therapy, diet therapy, liposomal curcumin therapy, vitamin D supplementation, artesunate injections, probiotic supplementation, Co-Q enzyme therapy, hyperbaric ozone therapy, medical cannabis, coffee enema, colour therapy, sun exposure, and yoga therapy. The treatment duration varied from person to person. All the patients have shown significant improvement in their complete blood cell counts, reduction in their cancer markers. The thermal scan has shown a complete arrest of disease activity in the breast compared to baseline. Further, all the patients have shown improvement in their body weight and expressed a complete revival of subjective wellbeing. The holistic integrative medicine protocol looks promising in the management of breast cancer. However, large-scale randomized control trials are warranted to validate the present findings.

Introduction

Sphincter of Oddi dysfunction (SOD) is a rare condition characterized by impaired function or mechanical aberrancy of the sphincter. Diagnosis involves evaluating clinical symptoms, laboratory tests, and imaging findings. This article presents a case of SOD type II characterized by a lack of biliary dilatation in conjunction with distal common bile duct (CBD) stones during diagnostic investigations.

Case

A 73-year-old woman with previous cholecystectomy presented with severe, intermittent epigastric pain radiating to the right upper quadrant over two months. Laboratory studies were significant for persistently elevated liver enzymes. After a thorough workup that included imaging, autoimmune studies and liver biopsy, SOD type II diagnosis was suspected and an endoscopic retrograde cholangiopancreatography (ERCP) was performed with a sphincterotomy. Thereafter, the patient’s symptoms had abated.

Discussion and conclusion

SOD is a complex clinical entity characterized by sphincter motility disorders that impede pancreatic or biliary fluid flow in the absence of structural abnormalities. Post-cholecystectomy SOD, affecting 1.5 % of patients, is more prevalent in women. Diagnosis involves excluding other pancreaticobiliary disorders through clinical evaluation, biochemical tests, and imaging. Management varies by subtype, with sphincterotomy showing efficacy in type I but less clear benefits in type II and III SOD. Challenges lie in the diagnosis and management of SOD type II due to overlapping symptoms and diagnostic limitations, necessitating further research to optimize therapeutic strategies and long-term outcomes.

Epiploic appendagitis is a rare underdiagnosed cause of acute abdominal pain often mimicking other severe causes of acute abdominal pain such as acute diverticulitis and appendicitis. However, with the emergence of CT imaging, accurate diagnosis of epiploic appendagitis can now be done with the avoidance of unnecessary hospitalization, antibiotic treatment, and surgery. In this case, we present a 50-year-old male patient who presented with a 3-day history of acute left lower abdominal pain and was diagnosed with epiploic appendagitis.

Background

Ménétrier’s disease (MD) is a rare condition characterized by prominently enlarged gastric folds at the level of the gastric body and fundus. The gastric antrum is usually spared. MD can present with a variety of symptoms: non-specific abdominal pain, nausea, vomiting, and peripheral edema. However, a localized MD manifesting as melena is an exceedingly rare condition.

Case presentation

A 51-year-old male patient sought medical care with a complaint of melena and a hemoglobin level of 7.0 g/dL. An esophagogastroduodenoscopy (EGD) was performed and revealed hypertrophic gastric folds at the level of the body and fundus. Biopsies revealed foveolar hyperplasia with corkscrewing and elongation of crypts, corroborating a diagnosis of MD. Patient was prescribed proton pump inhibitors (PPIs) and was scheduled for a follow-up with the gastroenterologist. An annual upper endoscopy was recommended due to the increased risk of gastric cancer.

Conclusion

While MD is a rare entity, the combination of MD and melena is exceedingly rare and atypical. This article highlights the fact that physicians should keep the diagnosis of MD in their differentials when dealing with a patient presenting with an upper gastrointestinal (GI) bleed and enlarged gastric mucosal folds on upper endoscopy.