-
Cureus Oct 2022Bezoar occurs due to the ingestion of inedible material. The most common bezoar is a phytobezoar, which results from the ingestion of indigestible food particles found...
Bezoar occurs due to the ingestion of inedible material. The most common bezoar is a phytobezoar, which results from the ingestion of indigestible food particles found in vegetables and fruits. Other types include trichobezoar, which involves hair, lactobezoar, which involves milk products, pharmacobezoar, which involves medication, and in unusual cases, bezoar may involve different materials such as metals, plastics, and paper. We are presenting a case of a 19-year-old patient, a known case of Prader-Willi syndrome, who presented with difficulty breathing and tachypnea after aspiration of grape particles, and then he started to complain of melena and vomiting of dark content. He was admitted for urgent bronchoscopy and endoscopy, which showed a bezoar composed of grapes and threads. He was managed endoscopically by removing most of the threads and grape particles and releasing the tangled threads to facilitate its migration distally. Follow-up endoscopy showed complete resolution of the previously noticed content. We reported this case to discuss the endoscopic management of unusual bezoar involving threads.
PubMed: 36348828
DOI: 10.7759/cureus.29900 -
Cureus Jul 2021Hemorrhagic cholecystitis -- a rare cause of hemobilia and melena -- is an atypical presentation of calculous cholecystitis, associated with significant morbidity and...
Hemorrhagic cholecystitis -- a rare cause of hemobilia and melena -- is an atypical presentation of calculous cholecystitis, associated with significant morbidity and mortality. A 75-year-old woman with multiple comorbidities, who was undergoing dual antiplatelet therapy, presented with symptoms of acute cholecystitis. Two days later, she developed melena and symptoms of obstructive jaundice. Following radiological evaluation, a diagnosis of hemorrhagic cholecystitis was made. The patient was managed conservatively with IV antibiotics and blood transfusion in the initial period (clopidogrel was withheld); an interval cholecystectomy was performed six weeks later. Hemorrhagic cholecystitis is a rare complication of acute cholecystitis, and its diagnosis is challenging as it mimics various other hepatopancreaticobiliary diseases. Management options include early surgery or conservative management at the initial stage, followed by interval cholecystectomy.
PubMed: 34306900
DOI: 10.7759/cureus.16385 -
British Medical Journal May 1970
Topics: Aged; Duodenal Ulcer; Humans; Methods; Peptic Ulcer Hemorrhage; Stomach Ulcer
PubMed: 5420194
DOI: 10.1136/bmj.2.5704.299 -
Canadian Medical Association Journal Sep 1970
Topics: Adolescent; Adult; Appendicitis; Blood Cell Count; Child; Child, Preschool; Enterobius; Enuresis; Eosinophils; Female; Genital Diseases, Female; Humans; Infant; Infant, Newborn; Intestinal Diseases, Parasitic; Male; Melena; Newfoundland and Labrador; Oxyuriasis; Rectal Diseases; Urinary Tract Infections
PubMed: 5469619
DOI: No ID Found -
Cureus Sep 2021Gastrointestinal Mucormycosis (GIM) is a rare life-threatening angio-invasive infection. The classic risk factors include immunosuppression and metabolic derangement....
Gastrointestinal Mucormycosis (GIM) is a rare life-threatening angio-invasive infection. The classic risk factors include immunosuppression and metabolic derangement. Usually, there are classical risk factors in patients affected by Ileocecal mucormycosis. Few case reports have shown the absence of salient clinical presentation of mucormycosis in prolonged hospitalisation. The presence of association of mucormycosis in patients of typhoid infection is rare. Here, we present a case of invasive ileal mucormycosis occurring as a sequel to typhoid infection which lacked the typical risk factors for mucormycosis.
PubMed: 34659961
DOI: 10.7759/cureus.17748 -
Medicina (Kaunas, Lithuania) Feb 2022Osler-Weber-Rendu disease, also known as hereditary hemorrhagic telangiectasia (HHT), is a rare, autosomal dominant condition that affects approximately 1 in 5000...
Osler-Weber-Rendu disease, also known as hereditary hemorrhagic telangiectasia (HHT), is a rare, autosomal dominant condition that affects approximately 1 in 5000 patients causing abnormal blood vessel formation. HHT patients have mucocutaneous telangiectasias and arteriovenous malformations in various organs. The most prominent symptom of HHT is epistaxis, which, together with gastrointestinal bleeding, may cause iron deficiency anemia. This study is a case report of a 62-year-old patient who was admitted to the Department of Gastroenterology due to acute upper gastrointestinal bleeding and a history of recurrent epistaxis and melena for 4 days, which was confirmed in digital rectal examination. Urgent upper gastrointestinal endoscopy revealed active bleeding from multiple angioectatic spots with bright-looking salmon-colored patches in the antrum and the body suggestive of HHT. The bleeding from two angioectatic spots was stopped by argon plasma coagulation, and four clips were placed to provide good hemostasis. The patient was treated with a proton pomp inhibitor infusion and iron infusion. She was discharged with no signs of GI bleeding, normalized iron levels and a diagnosis of HHT. She was referred to further genetic testing, including evaluation of first-degree relatives. She also had performed unenhanced thin-cut computed tomography (CT) with angiography to exclude the presence of pulmonary arteriovenous malformations (PAVMs). Due to the fact that the patient did not manifest any other HHT-related symptoms and that the instrumental screening discloses no silent AVMs in other organs, the "watch-and-wait strategy" was applied. Although, Osler-Weber-Rendu syndrome is widely described in the medical literature, effective treatment of gastrointestinal telangiectasias is not always available and still lacks standardization to date, which makes the management of gastroenterological involvement still a challenging issue.
Topics: Angiography; Female; Gastrointestinal Hemorrhage; Humans; Melena; Middle Aged; Telangiectasia, Hereditary Hemorrhagic; Tomography, X-Ray Computed
PubMed: 35334510
DOI: 10.3390/medicina58030333 -
Medicine Mar 2021Carcinosarcoma and sarcomatoid carcinoma of the stomach are rare, malignant, and biphasic tumors with high mortality. The differential diagnosis of these 2 diseases...
RATIONALE
Carcinosarcoma and sarcomatoid carcinoma of the stomach are rare, malignant, and biphasic tumors with high mortality. The differential diagnosis of these 2 diseases remains challenging. In the present study, we present 2 cases of carcinosarcoma and sarcomatoid carcinoma of the stomach.
PATIENT CONCERNS
A 54-year-old woman was admitted with complaints of epigastric pain for 4 months, but she became serious for 10 days accompanied by melena. A 75-year-old man was admitted with complaints of epigastric pain for 1 month.
DIAGNOSIS
The female had a Borrmann type III irregular ulcerative lesion (5.0 × 4.0 × 1.0 cm) originating from the gastric antrum. The male had Borrmann type I tumor polypoid exophytic (5.0 × 4.0 × 2.0 cm) in the fundus of stomach near the cardia. Both cases were identified as malignant neoplasms by endoscopic biopsy and further confirmed by performing laparoscopic proximal gastrectomy, esophagogastrostomy, and palliative distal subtotal gastrectomy. The postoperative histopathological morphology and immunohistochemistry studies revealed sarcomatoid carcinoma for the female and gastric carcinosarcoma for the male respectively.
INTERVENTIONS
The female patient subsequently underwent laparoscopy-assisted radical distal gastrectomy for gastric cancer followed by systemic chemotherapy with oxaliplatin plus tegafur. The male patient underwent laparoscopic proximal gastrectomy and esophagogastrostomy were performed.
OUTCOMES
The female had a mixture of a little poorly-differentiated adenocarcinoma and abundant sarcomatoid spindle cell elements, and is still alive healthy up to date for 2 and a half years after surgery by phone follow-up. The male patient had both adenocarcinoma and fibrosarcoma in a single tumor, and died 1 month after the operation.
LESSONS
The present study provides insight into the clinical findings, differential diagnosis, and prognosis of carcinosarcomas and sarcomatoid carcinomas of the stomach. More cases are needed for further studies in the future.
Topics: Abdominal Pain; Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma; Carcinosarcoma; Chemotherapy, Adjuvant; Diagnosis, Differential; Fatal Outcome; Female; Gastrectomy; Gastric Mucosa; Gastroscopy; Humans; Image-Guided Biopsy; Laparoscopy; Male; Melena; Middle Aged; Oxaliplatin; Stomach Neoplasms; Tegafur; Treatment Outcome
PubMed: 33761637
DOI: 10.1097/MD.0000000000024697 -
Medicine Jan 2019Considering the low incidence of colorectal follicular lymphoma (FL) and its clinical features in endoscopic views, only a few studies have described the pathological...
RATIONALE
Considering the low incidence of colorectal follicular lymphoma (FL) and its clinical features in endoscopic views, only a few studies have described the pathological diagnosis and treatment of this disease. This study aimed to reveal the overall process of clinical diagnosis and treatment of colorectal FL by conducting a case review.
PATIENT CONCERNS
A 27-year-old female presented to our department because of "severe bloody stool" lasting for more than 1 month. Her primary symptom was melena. Colonoscopy revealed widespread flat polyps with various immunophenotypes (CD10+, BCL2+, BCL6+, cyclin D1-, CD5-) in the colorectal area.
DIAGNOSIS
In accordance with manifestations on positron emission tomography-computed tomography (PET/CT), the patient was diagnosed with stage IV colorectal FL.
INTERVENTIONS
PET/CT reexamination after 2 courses of rituximab, cyclophosphamide, liposomal doxorubicin, vincristine sulfate, and hydroprednisone (R-CHOP) regimen and 3 courses of R-CHOP plus etoposide regimen for chemotherapy indicated a significant reduction in tumor burden. Subsequently, rituximab was administered alone in 2 treatment courses.
OUTCOMES
Lesions on PET/CT disappeared after reexamination. No recurrence was observed within the 12-month follow-up period.
LESSONS
Colorectal FL is a rare disease with an inert clinical course and is common in the ileocecal area. Endoscopic views show multiple polyps. Interventional treatment is usually provided after observation of clinical symptoms or during disease progression. The disease has a relatively good prognosis.
Topics: Adult; Aftercare; Antineoplastic Agents, Immunological; Antineoplastic Combined Chemotherapy Protocols; Colonoscopy; Colorectal Neoplasms; Female; Humans; Lymphoma, Follicular; Melena; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Rare Diseases; Rituximab; Treatment Outcome
PubMed: 30653103
DOI: 10.1097/MD.0000000000013985 -
BMC Pediatrics May 2018Henoch-Schönlein purpura is a common small vessel vasculitis in children. Acute pancreatitis rarely presents as a complication of Henoch-Schönlein purpura and has not...
BACKGROUND
Henoch-Schönlein purpura is a common small vessel vasculitis in children. Acute pancreatitis rarely presents as a complication of Henoch-Schönlein purpura and has not been well characterized.
METHODS
We retrospectively reviewed 13 cases of Henoch-Schönlein purpura with acute pancreatitis among 3212 patients who attended our hospital between January 2003 and June 2016 and analyzed their clinical characteristics, laboratory findings, imaging findings, treatment and overall prognosis.
RESULTS
All patients had abdominal manifestations, including significant abdominal pain (13/13), vomiting (9/13), abdominal distension (3/13) and melena (6/13). Serum amylase level significantly increased in all patients, and urine amylase was increased in 7 cases (7/10). However, increased urine lapse was only noted in 2 cases (2/5), and diffuse swelling of the pancreas was seen in 2 cases (2/13) by abdominal ultrasonography. Although all patients had typical skin purpura (13/13), 5 patients (5/13) with acute pancreatitis initially experienced acute abdominal pain in clinical onset of Henoch-Schönlein purpura. Glucocorticoid therapy was effective in alleviating abdominal symptoms of Henoch-Schönlein purpura patients with acute pancreatitis. All patients were in good general condition without any abdominal complications 6-12 months after discharge.
CONCLUSIONS
Acute pancreatitis is rarely observed in Henoch-Schönlein purpura children and has no specific clinical features that differentiate it from abdominal manifestations of Henoch-Schönlein purpura. Therefore, in Henoch-Schönlein purpura patients with severe abdominal pain, serum amylase levels should be assessed to confirm the diagnosis of acute pancreatitis. Early diagnose of Henoch-Schönlein purpura with acute pancreatitis and treatment timely was very important for good clinical outcomes.
Topics: Abdominal Pain; Acute Disease; Adolescent; Amylases; Child; Child, Preschool; Female; Glucocorticoids; Humans; IgA Vasculitis; Infant; Male; Melena; Methylprednisolone; Pancreatitis; Pulse Therapy, Drug; Retrospective Studies; Vomiting
PubMed: 29751784
DOI: 10.1186/s12887-018-1142-7 -
Postgraduate Medical Journal Jul 2004Acute upper gastrointestinal bleeding is a common medical emergency which carries hospital mortality in excess of 10%. The most important causes are peptic ulcer and... (Review)
Review
Acute upper gastrointestinal bleeding is a common medical emergency which carries hospital mortality in excess of 10%. The most important causes are peptic ulcer and varices. Varices are treated by endoscopic band ligation or injection sclerotherapy and management of the underlying liver disease. Ulcers with major stigmata are treated by injection with dilute adrenaline, thrombin, or fibrin glue; application of heat using the heater probe, multipolar electrocoagulation, or Argon plasma coagulation; or endoclips. Intravenous omeprazole reduces the risk of re-bleeding in ulcer patients undergoing endoscopic therapy. Repeat endoscopic therapy or operative surgery are required if bleeding recurs.
Topics: Adult; Aged; Aged, 80 and over; Combined Modality Therapy; Endoscopy, Gastrointestinal; Gastrointestinal Agents; Gastrointestinal Hemorrhage; Hematemesis; Hemostasis; Humans; Melena; Middle Aged; Risk Assessment
PubMed: 15254304
DOI: 10.1136/pgmj.2003.017558