Gastroenterology Commons^™

Case Of Enterococcus Cecorum Human Bacteremia, United States, Alexander D. Lake, Ryan Fields, Francia Guerrero, Yousef Almuzaini, Koravangala Sundaresh, Joseph Staffetti

HCA Healthcare Journal of Medicine

Enterococcus cecorum rarely serves as a human pathogen, and only 6 cases of this microbe inoculating humans have been documented. We present an elderly female with a marked vascular history presenting with epigastric pain and diarrhea, followed by shaking chills. Laboratory findings revealed leukocytosis, with imaging showing diffuse colonic thickening. She had a bout of bloody diarrhea, raising the likelihood of ischemic colitis with her vascular history. To our surprise, both sets of blood cultures drawn on admission grew Enterococcus cecorum. This case is unique as it is the first documented case of E. cecorum human infection in the …

Goblet Cell Carcinoma Of The Appendix: A Case Report On Goblet Cell Carcinoid, Sheliza Kabani, Aubtin Saedi, Austin Lehr, Lina O'Brien

HCA Healthcare Journal of Medicine

Goblet cell carcinoid of the appendix is a rare neoplasm with histological features of both neuroendocrine and adenocarcinomas. The combination of its aggressive behavior, infrequent occurrence, and variable clinical presentation convolutes the management of this tumor. We report the case of a 75-year-old female presenting with acute appendicitis. A laparoscopic appendectomy was performed. The pathology report showed goblet cell carcinoid at the base of the appendix with involvement of the proximal surgical margins. At her postoperative visit, the patient’s pathology report and options for management were reviewed, and the patient agreed to proceed with a right hemicolectomy 8-10 weeks after …

Type Iii Gastric Neuroendocrine Tumor: Case Report Of A Rare Gastric Carcinoma, Christopher L. Orpiano, Michael Quinn, Gurjeet Kang, Aric Tucker, Aric Tucker, Lakshminarasimhan Venu, Joseph Staffetti

Gastroenterology

No abstract provided.

Early Aggressive Hydration Is Associated With Decreased Opioid Use And Readmission In Mild Acute Pancreatitis, Shreyans Doshi, Hong Liang, Hale Z. Toklu, Selina Fritze, Sue-Wei Luu

HCA Healthcare Journal of Medicine

Background: Acute pancreatitis (AP) is one of the most common causes of hospital admissions due to gastrointestinal disorders. No pharmacologic agents have been proven to impact the prognosis, and the treatment still remains supportive with intravenous fluids for hydration. Although early hydration has been recommended for the management of mild AP, there is no consensus on the type, rate, and amount of the fluid replacement.

Objective: In this study, we aimed to investigate the outcome of aggressive hydration in patients with AP.

Methods: Retrospective data from patients admitted to 12 hospitals (2015–2017) was used for analysis. Five hundred patients who …

Gastroesophageal Reflux Disease: A General Overview, Julia Fashner

HCA Healthcare Journal of Medicine

Gastroesophageal reflux disease (GERD) varies in presentation and the patient’s symptoms of regurgitation in the throat or epigastric pain do not necessarily correlate with the severity of their disease. This general overview of GERD will include information on guidelines and diagnostic testing; lifestyle, medical and surgical management; and GERD in special populations. The pathophysiology of GERD is multifactorial, and a step-wise approach will assist physicians in making the diagnosis as GERD has a significant financial burden to the U.S. healthcare system.

Neuroendocrine Tumor Of The Gallbladder, A Rare Incidental Finding, Alvaro Frometa, Yasna Chaudhary, Omar Ansari, Nigel Jagoo, Iqbal Kapadia

HCA Healthcare Journal of Medicine

Background: Neuroendocrine tumors are a rare finding in the gallbladder. The incidence of this entity in the gallbladder is roughly 1.13 cases per 100,000 in the US, with a steady increase in the last decade. Gallbladder neuroendocrine tumors are generally asymptomatic; the majority of cases have been reported as incidental findings in specimens, resected due to secondary symptomatology, such as chronic cholecystitis. Treatment strategies are limited, in part due to the often advanced stage in which this disease presents. Furthermore, there is a restricted utility of diagnostic tools for early detection; these factors contribute to the poor prognosis of this …

Internal Hernia As A Late Complication Of Roux-En-Y Gastric Bypass Procedure, Samantha Purton, Gabriel Meshekow, My Myers, Edgar Mercado, Allan Katz

West Florida Division GME Research Day 2020

As the prevalence of obesity continues to rise, so does the popularity of bariatric surgery. Previously the Roux-en-Y gastric bypass was the most common bariatric procedure, but now falls second to the gastric sleeve. It remains a relevant procedure, however, accounting for 17% of bariatric procedures in 2018. Due to its prevalence, it is important that the radiologist be familiar with the procedure and its complications such as leak, obstruction, stricture, or, as in this case, internal herniation through a mesenteric defect. Internal hernias are more commonly associated with the laparoscopic approach versus open. This is likely due to fewer …

A Rare Cause Of Pneumoperitoneum, Robert Zusman, George Michael, Anna E. Augustin, My Myers, Dudith Pierre-Victor

West Florida Division GME Research Day 2020

Pneumoperitoneum is most commonly associated with a perforated viscus. When free air is seen on imaging, the most common course of action is an emergent exploratory laparotomy. However, pneumoperitoneum may not always be indicative of a perforated bowel. In the case described below, we will discuss a patient who developed acute peritonitis and pneumoperitoneum after undergoing chest compressions during cardiopulmonary resuscitation (CPR) and positive pressure mechanical ventilation.

A Rare Case Of Perforated Jejunal Diverticulitis, Mohamed Nagi Md, Stanley Deturris Md, Ang Darwin

General Surgery

Introduction: Jejunal diverticulosis is a rare condition with clinical incidence of 0.5%. It is less common than colonic and duodenum diverticulosis. It is usually asymptomatic and diagnosed incidentally but it may cause chronic symptoms and acute complications. The aim of the case report to increase the awareness about the disease Case Report: This is a 56-year-old Caucasian male who presented with abdominal pain and fever and was diagnosed with transverse colon diverticulitis with microperforation on CT scan. Patient was treated nonoperatively with antibiotics and was discharged home. Two months later, he presented with similar recurrent abdominal pain and was found …

Bradycardia In The Setting Of Gastric Sarcoidosis, Kameron Black Mph, Michelle Levine Do, Rage Geringer Md, Gregory Hicks Md, Oliwier Dziadkowiec

Internal Medicine

No abstract provided.

Metastatic Leiomyosarcoma Presenting As Polycystic Liver Disease, Michael Burkholz Do, Apurva Modi Md

Gastroenterology

No abstract provided.