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Intussusception in the Setting of an Ulcerative Colitis Flare 溃疡性结肠炎暴发的肠套叠
IF 0.7 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2022-05-30 DOI: 10.1155/2022/3559464
V. Abed, Alexis Faber, Cristina Jageka, Ryan Goleniak, R. Fadel
Intussusception is an extraordinary cause of acute abdomen in adults and has been defined as the telescoping of a bowel segment into the lumen of an adjacent segment. A 43-year-old female presented to our hospital's emergency department (ED) with 10+ episodes of bloody diarrhea per day, left-sided abdominal pain, and the inability to tolerate oral intake for one month. She was initially diagnosed with ulcerative colitis (UC) ten years ago and is currently on mesalamine oral and enema therapy. She presented to our gastroenterology clinic two weeks after the beginning of her flare and was started on prednisone 40 mg daily. This did not improve her symptoms, and she presented to the ED two weeks later. She underwent a computed tomography (CT) abdomen/pelvis which revealed intussusception in the left hemiabdomen with no definite lead point measuring 5.6 cm in the craniocaudal dimension with pneumatosis and no evidence of bowel obstruction. There were no other significant laboratory abnormalities. Acute care surgery was consulted and suggested obtaining a CT enterography for further evaluation which showed spontaneous resolution of intussusception with no evidence of pneumatosis, portal venous gas, or intraperitoneal free air. She reports that following oral contrast intake, she “felt movement and relaxation” in her abdomen with substantial pain relief. Infectious workup was negative, and therapy was initiated with intravenous steroids. In conclusion, intussusception has been very rarely reported in patients with UC with the most common treatment being surgical resection. However, conservative management in the absence of bowel obstruction can be attempted.
肠套叠是成人急腹症的一个特殊原因,它被定义为肠段延伸到相邻肠段的管腔。一名43岁女性,因每天10次以上带血腹泻,左侧腹痛,不能耐受口服一个月就诊于我院急诊科。她最初被诊断为溃疡性结肠炎(UC)十年前,目前正在美沙拉明口服和灌肠治疗。她在发作两周后来到我们的胃肠病学诊所,开始服用强的松,每天40毫克。这并没有改善她的症状,两周后她去了急诊科。她接受了腹部/骨盆计算机断层扫描(CT),发现左半腹部肠套叠,没有明确的引导点,颅侧尺寸为5.6 cm,伴有肺积症,没有肠梗阻的证据。没有其他明显的实验室异常。我们咨询了急诊外科医生,并建议做CT肠造影进一步评估,结果显示肠套叠自行消退,无气胸、门静脉气体或腹腔内游离空气。她报告说,口服造影剂后,她的腹部“感到运动和放松”,疼痛明显减轻。感染检查呈阴性,并开始静脉注射类固醇治疗。总之,肠套叠在UC患者中很少报道,最常见的治疗方法是手术切除。然而,在没有肠梗阻的情况下,可以尝试保守治疗。
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引用次数: 0
Mucinous Signet-Cell Adenocarcinoma of the Ileum: A Diagnostic Challenge—Case Report and Review of the Literature 回肠黏液印细胞腺癌:诊断上的挑战-病例报告及文献回顾
IF 0.7 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2022-05-28 DOI: 10.1155/2022/5703407
T. Martins, Jalaluddin Umar, Kevin Groudan, H. Bharadwaj, D. Desilets
Malignancies of the small intestine are rare. Signet-ring cell carcinoma (SRCC) is one of the rarest forms of adenocarcinoma that can arise in the small intestines. We present a case of a patient who originally presented with abdominal pain and radiographic findings suggestive of ileal congestion. The ileal biopsy specimens were nonspecific, and the patient began a trial of corticosteroid treatment for suspected Crohn's disease. A repeat colonoscopy yielded biopsies that were positive for malignancy. The patient then underwent an exploratory laparotomy which led to the diagnosis of SRCC. Given their similar presentations and the extreme rarity of this unusual malignancy, it can be difficult to differentiate between new-onset Crohn's disease and SRCC. A review of the literature was conducted to provide us with an improved understanding of previously documented cases of SRCC.
小肠恶性肿瘤是罕见的。印戒细胞癌(SRCC)是发生在小肠的最罕见的腺癌之一。我们提出一个病例的病人谁最初提出腹部疼痛和放射检查结果提示回肠充血。回肠活检标本是非特异性的,患者开始接受疑似克罗恩病的皮质类固醇治疗试验。复查结肠镜检查结果为恶性肿瘤阳性。患者随后接受了探查性剖腹手术,诊断为SRCC。考虑到它们相似的表现和这种罕见的恶性肿瘤,很难区分新发克罗恩病和小细胞癌。我们对文献进行了回顾,以使我们更好地了解以前记录的SRCC病例。
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引用次数: 3
Report of a Misleading Case of the Superior Mesenteric Artery Syndrome 误读肠系膜上动脉综合征一例报告
IF 0.7 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2022-05-27 DOI: 10.1155/2022/6013579
A. Salehi, H. Salehi, Maryam Hasanzarrini, E. Khanlarzadeh
Superior mesenteric artery syndrome (SMAS), which is also known as the cast syndrome, Wilkie's syndrome, or chronic duodenal ileus, is a specific type of duodenal obstruction characterized by the obstruction of the inferior part of the duodenum due to its compression between the superior mesenteric artery (SMA) and the aorta. This problem is usually resulting from loss of the mesenteric fat pad. The present report describes a case of SMAS who was an 18-year-old woman presenting with weight loss and postprandial pain. The patient was initially diagnosed with Helicobacter pylori infection and underwent antibiotic therapy. However, the related symptoms did not resolve. Finally, she was ordered a CT scan, which led to the diagnosis of SMAS.
肠系膜上动脉综合征(SMAS)又称铸型综合征、Wilkie综合征或慢性十二指肠肠梗阻,是十二指肠梗阻的一种特殊类型,其特征是由于肠系膜上动脉(SMA)与主动脉之间的压迫导致十二指肠下段梗阻。这个问题通常是由于肠系膜脂肪垫的丢失。本报告描述了一个18岁女性的SMAS病例,她表现为体重减轻和餐后疼痛。患者最初被诊断为幽门螺杆菌感染,并接受了抗生素治疗。但是,相关症状没有解决。最后,医生给她做了CT扫描,结果确诊为SMAS。
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引用次数: 0
Silica Desiccant Canister: An Unusual Colonic Foreign Body 二氧化硅干燥剂罐:一种不寻常的结肠异物
IF 0.7 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2022-05-27 DOI: 10.1155/2022/9917884
Rajarajeshwari Ramachandran, Vikash Kumar, Giovannie Isaac-Coss, D. Etienne
We are reporting a case of incidental identification and removal of two silica desiccant canisters from the cecum in a patient undergoing screening colonoscopy.
我们报告一个病例,偶然发现和去除两个二氧化硅干燥剂罐从盲肠在一个病人进行筛查结肠镜检查。
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引用次数: 0
Crohn's Disease Diagnosed in a Man with Sarcoidosis: Coincidence or Correspondence? 克罗恩病诊断为结节病:巧合还是对应?
IF 0.7 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2022-05-27 DOI: 10.1155/2022/5943468
Krystal Mills, S. Fatima, N. Fas
Crohn's disease and sarcoidosis are characterized by noncaseating granulomas, but rarely do they present in the same patient. Their coexistence presents a diagnostic challenge as they are often classified as clinically separate, despite their similarities. We present a case of a 59-year-old man previously diagnosed with pulmonary sarcoidosis who presented to the emergency room with abdominal pain and diarrhea. Colonoscopy revealed multiple ulcers in the colon, with histology in keeping with newly diagnosed Crohn's colitis. The patient had a good clinical response to initiation of steroid therapy and a tumor necrosis factor (TNF) inhibitor.
克罗恩病和结节病以非干酪化肉芽肿为特征,但很少出现在同一患者身上。它们的共存给诊断带来了挑战,因为尽管它们有相似之处,但它们通常在临床上被分类为独立的。我们提出一个59岁的男子以前诊断为肺结节病谁提出了腹痛和腹泻的急诊室。结肠镜检查显示结肠多处溃疡,组织学符合新诊断的克罗恩结肠炎。患者对开始类固醇治疗和肿瘤坏死因子(TNF)抑制剂有良好的临床反应。
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引用次数: 0
Intestinal Tuberculosis Presenting with Gastrointestinal Bleeding in Patient on Warfarin Therapy 肠结核患者在华法林治疗中出现胃肠道出血
IF 0.7 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2022-05-14 DOI: 10.1155/2022/9277789
Werimo Pascal Kuka, Joe Rakiro, J. Gatheru, F. Riunga, A. Rajula
Background Intestinal tuberculosis (ITB) constitutes less than 5% of overall cases of extrapulmonary disease and mostly affects the ileocecal region. The presentation and radiologic findings in enteric tuberculosis can mimic Crohn's disease (CD). Case Presentation. We present a case report of an African woman who presented to a Kenyan hospital with lower gastrointestinal bleeding while on anticoagulation for valvular atrial fibrillation, and was diagnosed with intestinal tuberculosis after colonoscopy, biopsy, and positive staining for tuberculous bacilli. Conclusion Intestinal tuberculosis causing gastrointestinal bleeding is rare but should be suspected in patients living in TB endemic regions.
背景肠结核(ITB)占肺外疾病总数的不到5%,主要影响回盲区。肠结核的表现和影像学表现与克罗恩病(CD)相似。案例演示。我们提出一个病例报告,一个非洲妇女提出了下消化道出血的肯尼亚医院,同时抗凝治疗瓣膜性房颤,并被诊断为肠结核结肠镜检查,活检和阳性染色结核杆菌。结论在结核病流行地区,肠结核引起消化道出血的病例较为罕见,但应予以怀疑。
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引用次数: 0
Synchronous Gastric Adenocarcinoma and Diffuse Large B-Cell Lymphoma in the Pelvis: A Rare Case Presentation 盆腔内同步胃腺癌及弥漫性大b细胞淋巴瘤一例
IF 0.7 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2022-04-28 DOI: 10.1155/2022/7535036
E. Pliakou, D. Lampropoulou, N. Soupos, G. Aravantinos
Multiple primary cancer (MPC) is defined as more than one primary tumour diagnosed at the same patient, either simultaneously or sequentially. Its incidence is low and varies in reporting among medical centers. Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma (NHL) while gastric cancer (GC) is the fifth most frequently diagnosed malignancy. The aim of this article is to present a rare case of a female patient who was diagnosed with two synchronous malignancies, an adenocarcinoma of the stomach (SRCC) and an aggressive extranodal NH lymphoma (DLBCL) within 2 months. Given the fact that there is an expanding availability of more sensitive diagnostic and screening methods, we aim to increase surveillance amongst medical doctors and provide valuable information for further systematic analysis and identification of such rare cases of concurrent malignancies.
多发性原发癌(MPC)被定义为同一患者同时或先后诊断出多个原发肿瘤。它的发病率很低,各医疗中心的报告也各不相同。弥漫性大b细胞淋巴瘤(DLBCL)是最常见的非霍奇金淋巴瘤(NHL)亚型,而胃癌(GC)是第五大最常诊断的恶性肿瘤。本文的目的是报告一例罕见的女性患者,她在2个月内被诊断为两种同步恶性肿瘤,即胃腺癌(SRCC)和侵袭性结外NH淋巴瘤(DLBCL)。鉴于越来越多更敏感的诊断和筛查方法的可用性,我们的目标是加强医生之间的监测,并为进一步系统分析和识别此类罕见的并发恶性肿瘤病例提供有价值的信息。
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引用次数: 3
Recurrent Ileal Variceal Bleeding as a Diagnostic and Therapeutic Challenge 复发性回肠静脉曲张出血作为诊断和治疗的挑战
IF 0.7 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2022-04-26 DOI: 10.1155/2022/7072961
Marek Cingel, J. Benko, M. Samoš, M. Mokáň
Introduction Massive ileal variceal bleeding is a rare intricate condition that needs rapid management and treatment. The absence of randomized clinical trials in this field leads to a lack of evidence-based diagnostic and therapeutical approaches. We present a case report describing imaging, endoscopic, and surgical procedures leading to the diagnosis and resolution of severe ileal variceal bleeding. Case Report. We admitted a 63-year-old patient for recurrent anemia and ongoing bleeding from the gastrointestinal tract presenting as enterorrhagia. We were not able to elucidate the source by endoscopic, angiographic, or nuclear imaging methods. As a last resort, we carried out a surgical procedure with peroperative enteroscopy and subsequent resection of the affected part of the intestine. Conclusion We present a patient with a case of ileal variceal bleeding, which required extensive diagnostic and therapeutic effort with a unique peroperative enteroscopic approach.
大量回肠静脉曲张出血是一种罕见的复杂情况,需要快速管理和治疗。该领域缺乏随机临床试验,导致缺乏循证诊断和治疗方法。我们提出一个病例报告描述成像,内窥镜和外科手术导致严重回肠静脉曲张出血的诊断和解决。病例报告。我们收治了一位63岁的复发性贫血和持续出血的胃肠道表现为肠出血的病人。我们无法通过内窥镜、血管造影或核成像方法阐明其来源。作为最后的手段,我们进行了外科手术,术中肠镜检查和随后切除受影响的肠道部分。结论我们报告了一例回肠静脉曲张出血的病例,需要广泛的诊断和治疗努力,并采用独特的术中肠镜方法。
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引用次数: 0
A Case of Systemic AL Amyloidosis Diagnosed by Screening Colonoscopy 结肠镜筛查诊断系统性AL淀粉样变1例
IF 0.7 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2022-04-20 DOI: 10.1155/2022/5562281
L. Alnimer, A. Zakaria, J. Patel, Y. Samhouri, S. Ahsan, Lyle S. Goldman, S. Sorser
Amyloidosis encompasses several diseases associated with deposition of low-molecular-weight proteins in an abnormal configuration. In light-chain amyloidosis (AL), monoclonal free lambda (λ) or kappa (κ) light chains are the amyloid proteins involved and can deposit in almost any organ. Symptoms vary depending on presence and extent of organ involvement, and thus, clinical presentation varies. Diagnosis requires biopsy of the affected tissue, and sometimes, fat pad or bone marrow biopsy is completed initially. Prognosis of AL amyloidosis depends on the presence of cardiac involvement. Treatment of AL amyloidosis involves systemic chemotherapy and evaluation for autologous stem cell transplant. Herein, we present a case report of an asymptomatic middle-aged female who was diagnosed with AL amyloidosis during an average-risk screening colonoscopy, which is an unusual setting. We discuss the workup involved, clinical presentation, and gastroenterology-related organ involvement.
淀粉样变性包括几种与低分子量蛋白异常结构沉积相关的疾病。在轻链淀粉样变性(AL)中,单克隆游离lambda (λ)或kappa (κ)轻链是涉及的淀粉样蛋白,可以沉积在几乎任何器官中。症状因器官的存在和受累程度而异,因此临床表现也各不相同。诊断需要对受影响的组织进行活检,有时最初需要完成脂肪垫或骨髓活检。AL淀粉样变的预后取决于是否累及心脏。AL淀粉样变的治疗包括全身化疗和自体干细胞移植的评估。在此,我们报告一例无症状的中年女性,在平均风险筛查结肠镜检查中被诊断为AL淀粉样变,这是一个不寻常的情况。我们讨论所涉及的检查,临床表现和胃肠相关器官受累。
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引用次数: 0
Two Cases of Duodenal Ulcers That Developed after Transcatheter Procedures for Unruptured Visceral Artery Aneurysms 未破裂的内脏动脉瘤经导管治疗后发生十二指肠溃疡2例
IF 0.7 Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2022-04-07 DOI: 10.1155/2022/9988216
M. Iwamuro, Yusuke Kawai, M. Uka, Y. Matsui, T. Hiraki, Y. Kawahara, H. Okada
Herein, we report two cases of duodenal ulcers that developed after transcatheter procedures for the treatment of unruptured artery aneurysms. Both patients recovered after the administration of nothing by mouth, intravenous fluids, and proton-pump inhibitors. Notably, the duodenal ulcer was unchanged in one patient six days after endovascular treatment and improved in the other patient 13 days after angiography. These cases suggest that conservative treatment is acceptable in patients with duodenal ischemia that develops as an adverse effect of endovascular procedures. The usefulness of esophagogastroduodenoscopy in such patients has also been highlighted.
在此,我们报告两例经导管治疗未破裂动脉瘤后发生的十二指肠溃疡。两例患者均在未给予口服、静脉输液和质子泵抑制剂治疗后恢复。值得注意的是,一名患者在血管内治疗6天后十二指肠溃疡没有变化,另一名患者在血管造影13天后十二指肠溃疡有所改善。这些病例表明,保守治疗是可接受的十二指肠缺血患者发展为血管内手术的不良反应。食管胃十二指肠镜检查在此类患者中的作用也得到了强调。
{"title":"Two Cases of Duodenal Ulcers That Developed after Transcatheter Procedures for Unruptured Visceral Artery Aneurysms","authors":"M. Iwamuro, Yusuke Kawai, M. Uka, Y. Matsui, T. Hiraki, Y. Kawahara, H. Okada","doi":"10.1155/2022/9988216","DOIUrl":"https://doi.org/10.1155/2022/9988216","url":null,"abstract":"Herein, we report two cases of duodenal ulcers that developed after transcatheter procedures for the treatment of unruptured artery aneurysms. Both patients recovered after the administration of nothing by mouth, intravenous fluids, and proton-pump inhibitors. Notably, the duodenal ulcer was unchanged in one patient six days after endovascular treatment and improved in the other patient 13 days after angiography. These cases suggest that conservative treatment is acceptable in patients with duodenal ischemia that develops as an adverse effect of endovascular procedures. The usefulness of esophagogastroduodenoscopy in such patients has also been highlighted.","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"75 4 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90571227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
期刊
Case Reports in Gastrointestinal Medicine
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