Gastroenterology Commons^™

Presence And Implications Of Sarcopenia In Non-Alcoholic Steatohepatitis., Gregory Habig, Christa Smaltz, Dina Halegoua-De Marzio

Department of Medicine Faculty Papers

Sarcopenia, defined as the loss of muscle strength, mass, and functionality, confers a poor prognosis in the setting of cirrhosis. Given its clinical significance, a better understanding of the underlying mechanisms leading to cirrhosis, sarcopenia, and their co-occurrence may improve these patients' outcomes. Non-alcoholic steatohepatitis (NASH) shares many of the same etiologies as sarcopenia, including insulin resistance, chronic inflammation, and ectopic adipocyte deposition, which are hallmarks of metabolic syndrome (MS). NASH thus serves as a prime candidate for further exploration into the underlying pathophysiology and relationship between these three conditions. In this review, we discuss the natural history of NASH …

Brucella Melitensis-Induced Transaminitis., Rajesh Essrani Md, Anastasia Shnitser Md

Department of Medicine

Brucellosis is infrequently reported in the United States and is mostly an occupational hazard among workers engaged in livestock raising and processing. It is a systemic infectious disease and can involve the liver in varying ways, ranging from benign subclinical increases in serum aminotransferase levels to ominous chronic suppurative disease. It is endemic in many countries, primarily those of the Mediterranean region. It is usually treated with antibiotics. We present a case of a 37-year-old female who developed

Successful Treatment Of Splenic Vein Thrombosis Induced Gastric Varices During Pregnancy, Travis Magdaleno Md, Anam Malik Md, She-Yan Wong Md

Department of Medicine

No abstract provided.

A Young Male With Cholestatic Jaundice Induced By Dymethazine Present In Nutritional Supplement “Xtreme Dmz”, Michal Kloska Md, Reema M. Vaze Md, Travis Magdaleno Md, She-Yan Wong Md

Department of Medicine

No abstract provided.

Transoral Incisionless Fundoplication In A Treatment Of Refractory Gerd: A Retrospective Experience At A Large Quaternary Care Center, Michal Kloska Md, Abdul Aleem Md, Valery Hrad Md, Hiral N. Shah Md, Scott Beman Md, Shashin Shah Md

Department of Medicine

No abstract provided.

Brucella Melitensis-Induced Transaminitis, Rajesh Essrani Md

Department of Medicine

No abstract provided.

Vomiting-Induced Gastric Pneumatosis And Portal Venous Gas, Rajesh Essrani Md

Department of Medicine

No abstract provided.

Idiopathic Isolated Thrombosis Of The Superior Mesenteric Vein, Rajesh Essrani Md

Department of Medicine

No abstract provided.

Axios Lumen Apposing Metal Stent In The Treatment Of Peripancreatic Fluid Collections, 4 Year Retrospective Observation At A Large Care Center, Michal Kloska Md, Valery Hrad Md, Abdul Aleem Md, Soorya N. Aggarwal Do, Shashin Shah Md, Zachary Zator Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Barriers To Psychosocial Support And Quality Of Life For Patients With Inflammatory Bowel Disease: A Survey Study, Rebecca Lawrence, Md, Cuckoo Choudhary, Md

Department of Medicine Faculty Papers

Background: Psychological comorbidities are common among people with inflammatory bowel disease (IBD) and are associated with worse disease outcomes. Evidence-based psychotherapy is an effective means to increase psychosocial support. This study aimed to identify the barriers to attending psychotherapy.

Methods: This electronic survey study included a demographic, quality of life, and barriers to psychotherapy questionnaire. Quality of life was assessed using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Barriers were assessed using the Perceived Barriers to Psychological Treatments scale (PBPT). Linear regression was used to identify participant characteristics associated with higher PBPT scores.

Results: One hundred eighty-seven …

Unique Case Of Gastroenteritis Presenting As Pneumatosis Intestinalis With Emphysematous Gastritis And Portal Vein Gas: Do Not Take Gastroenteritis Lightly., Asif Mehmood, Rajesh Essrani Md, Swetha Parvataneni, Umair Iqbal

Department of Medicine

Pneumatosis intestinalis (PI) consists of multiple, thin, gas-filled cysts in the wall of the gastrointestinal (GI) tract. It is an uncommon entity that can involve any gastrointestinal site from the stomach to the rectum. Isolated stomach involvement is rare. PI can represent a broad spectrum of diseases with variable prognoses. We present the case of a patient who was admitted with gastroenteritis-like symptoms. He remained hemodynamically stable, and on further imaging with contrast-enhanced computed tomography of the abdomen and pelvis, air was found in the portal vein and gastric wall, with minimal thickening of the proximal small bowel concerning for …

A Patient With Chronic Lymphocytic Leukemia With Pancreatic Involvement, Rajesh Essrani Md, Matthew J. Sullivan Do, Hiral N. Shah Md

Department of Medicine

A 78-year-old female with a past medical history of hypertension, type 2 diabetes mellitus, and chronic lymphocytic leukemia was hospitalized for poor appetite, weight loss, and night sweats. On physical exam, there was no palpable lymphadenopathy, and her abdomen was soft and nondistended. Laboratory results showed a hemoglobin count of 13.3 g/dl, hematocrit 41.3%, white blood cell 68.4 × 103 μL with lymphocytes 92.0%, total bilirubin 0.4 mg/dL, aspartate transaminase 14 U/L, and alanine transaminase 15 U/L. CT of the chest, abdomen, and pelvis showed hypodense lesions within the pancreatic body (1.4 × 1.4 cm) and medial aspect of …

Chronic Lymphocytic Leukemia Of The Liver: A Rare Cause Of Elevated Liver Function Tests, Ricky Buckshaw Do, Anam Malik Md, Michal Kloska Md, Reema M. Vaze Md, She-Yan Wong Md

Department of Medicine

No abstract provided.

Intestinal Tuberculosis In An Immunocompetent Patient, Reema M. Vaze Md, Anam Malik Md, Ricky Buckshaw Do, Michal Kloska Md, Abdul Aleem Md, Frederic Stelzer Md

Department of Medicine

No abstract provided.

Metastatic Renal Cell Carcinoma To The Small Bowel: A Rare Cause Of Gastrointestinal Hemorrhage, Ricky Buckshaw Do, Anam Malik Md, Reema M. Vaze Md, Michal Kloska Md, Robert Andrews Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Can We Predict Low Quality Colonoscopy? Establishing Open Access Colonoscopy At A Fellow-Run Gastroenterology Clinic, Matthew Sullivan Do, Abdul Aleem Md, Rajesh Essrani Md, Patrick Hickey Do, Robert Andrews Md, Anam Malik Md, Hiral N. Shah Md, Shashin Shah Md

Department of Medicine

No abstract provided.

Small Bowel Variceal Bleeding Successfully Treated With Percutaneous Coil Embolization, Anam Malik Md, Reema M. Vaze Md, Ricky Buckshaw Do, Michal Kloska Md, Eric Nellis Md, She-Yan Wong Md

Department of Medicine

No abstract provided.

A Case Of Cmv Colitis Seen In Dress, Anam Malik Md, Reema M. Vaze Md, Ricky Buckshaw Do, Eric Nellis Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Umbilical Hernia Rupture Complicated By Enterocutaneous Fistula In 63-Years-Old Female With Decompensated Nash Cirrhosis, Michal Kloska Md, Phd, Matthew J. Sullivan Do, Adam Peyton Do, Waqas Adeel

Department of Medicine

No abstract provided.

Endoscopic Ultrasound-Guided Drainage Of Pancreatic Fluid Collections Using Axios™ Electrocautery Enhanced Delivery System: A Retrospective Experience At A Large Quaternary Care Center, Michal Kloska Md, Phd, Valery Hrad Md, Soorya N. Aggarwal Do, Shashin Shah Md, Zachary Zator Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

69-Year-Old Male After Gastric Bypass With Choledocholithiasis Treated With Edge Procedure Complicated By Lams Dislocation, Michal Kloska Md, Phd, Reema M. Vaze Md, Ricky Buckshaw Do, Hiral N. Shah Md

Department of Medicine

No abstract provided.

A Rare Case Of Biliary Pancreatitis Caused By Ampullary Somatostatinoma In A 46-Year-Old Female, Michal Kloska Md, Phd, Reema M. Vaze Md, Ricky Buckshaw Do, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Initial Experience Of A Community Gastroenterology Practice With Ultraslim Colonoscopy., Rajesh Essrani, Patrick Hickey Do, Hiral N. Shah Md

Department of Medicine

Colonoscopies are performed for cancer screening as well as for other diagnostic and therapeutic reasons. It is considered successful if cecal intubation is achieved and adequate mucosa is visualized. It is not always possible to achieve cecal intubation due to multiple reasons such as sharp angulation or fixed segments of the colon and stricture. A pediatric colonoscope (PDC) and an ultrathin colonoscope (UTC) are used as a tool to negotiate sharp angulation and the fixed segments of the colon because their small diameter allows easy movement. An ultrathin colonoscope is used at many practices as a rescue in situations where …

Chronic Urticaria Associated With Helicobacter Pylori., Rajesh Essrani Md, Matthew Sullivan Do, Hiral N. Shah Md

Department of Medicine

A 31-year-old male presented with a complaint of chronic pruritus with diffuse urticarial wheals for the past seven months. He underwent extensive workup and was found to have positive Helicobacter pylori (H. pylori) stool antigen test. He was treated with bismuth subsalicylate, metronidazole, tetracycline, and omeprazole for two weeks. Pruritus and urticarial wheals disappeared in four weeks after therapy was started.

Esophageal Necrosis: A Rare Complication Of Diabetic Ketoacidosis – A Case Report, Ricky Buckshaw Do, Ethan S. Stern Do, Robert Andrews Md, Frederic Stelzer Md

Department of Medicine

No abstract provided.

Metastatic Melanoma To The Stomach: A Rare Cause Of Upper Gastrointestinal Bleeding, Ricky Buckshaw Do, Robert V. Decker Md, Shashin Shah Md

Department of Medicine

No abstract provided.

Unusual Case Of Obstructive Jaundice., Rajesh Essrani Md, Eric Nellis Md, Patrick Hickey Do, Hiral N. Shah Md

Department of Medicine

Most malignant obstructive jaundice arises from primary periampullary tumors and rarely from metastatic cancer of the head and neck. A 60-year-old male was diagnosed with obstructive jaundice due to metastatic squamous cell carcinoma of the tonsil. Only 12 cases of small bowel metastasis from the head and neck have been reported. Most of them originate from laryngeal squamous cell carcinoma, and only one case reported tonsillar cancer metastasizing to the ileum. Our case is the first one, to the best of our knowledge, to illustrate tonsillar cancer with metastasis to the duodenum causing obstructive jaundice.

Denture Misadventure: The Tooth About Your Colon., Rajesh Essrani Md, Patrick Hickey Do, Hiral N. Shah Md

Department of Medicine

Foreign body ingestion occurs mainly in a mentally impaired person, but rarely in healthy adults. A 48-year-old male was admitted with a recurrence of previously diagnosed right knee septic arthritis and accidentally ingested his dental bridge which was removed from a proximal ascending colon with a colonoscopy.

Oculomotor Nerve Palsy After Influenza Vaccine In Inflammatory Bowel Disease., Rajesh Essrani Md, Rajesh K Essrani, Shehriyar Mehershahi, Arjun K Lohana, Anuraj Sudhakaran

Department of Medicine

Influenza and pneumococcal vaccines are recommended in inflammatory bowel disease patients. Several neurologic complications have been reported after influenza vaccines, such as Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy, and acute disseminated encephalomyelitis; however, rarely, oculomotor palsy will occur. We report the case of a 23-year-old male with a past medical history of ulcerative colitis on sulfasalazine who presented to the hospital with a complaint of blurry vision five days after an influenza vaccine. Most of the possible causes of oculomotor nerve palsy, such as stroke, intracranial space-occupying lesions, aneurysms, and infections, were ruled out by history, physical exam, blood work, …

Over-The-Scope Clip Defect Closure Following Endoscopic Mucosal Resection Throughout The Gastrointestinal Tract: A Case Series, Kyle Kreitman Do, Patrick Hickey Do, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.