Digestive System Diseases Commons^™

Salvage Percutaneous Spyglass-Assisted Lithotripsy Via A Cholecystostomy Tract After Failed Ercp: A Case Report, Nicholas Gerden, Tiffany Hong, Asad Rehman, Long Hoang

North Texas GME Research Forum 2026

IR-driven percutaneous cholangioscopy with SpyGlass-assisted lithotripsy is an emerging salvage technique for biliary stone disease in patients with failed or contraindicated endoscopic retrograde cholangiopancreatography (ERCP) due to complex anatomy. We report an 85-year-old patient with an indwelling cholecystostomy tube and biliary stent who presented with recurrent obstructive jaundice, with cholangiography demonstrating occlusion of the common bile duct stent due to choledocholithiasis. Conventional ERCP was unsuccessful because of complex biliary and gastrointestinal anatomy. A multidisciplinary interventional radiology–gastroenterology approach was therefore pursued, utilizing antegrade percutaneous choledochoscopy through an existing cholecystostomy tract with SpyGlass-assisted lithotripsy, followed by cholecystostomy tube exchange. The procedure resulted …

Robotic Cholecystectomy With Choledochoscopy After Failed Ercp: A Case Report, James Zhang, Ethan Pavlovsky, Jennifer Austin, Furrukh Jabbar, Hassan Ahmed

North Texas GME Research Forum 2026

Background: In the United States, there are an estimated 20 million cases of cholelithiasis, though a majority remain asymptomatic. Development of choledocholithiasis is seen in 10%-20% of those with cholelithiasis. Typically, choledocholithiasis is managed via a two-stage approach starting with endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy on the same admission. More recent trends have seen a shift towards surgeon-directed management of the common bile duct through one-stage procedures that combine cholecystectomy with intraoperative common bile duct (CBD) exploration using choledochoscopy. We present a case of chronic choledocholithiasis with large, impacted gallstones that was managed with robotic cholecystectomy, choledochotomy, …

Extra-Intestinal Clostridioides Difficile Abscess In A Small Bowel Gist: A Rare Tumor-Associated Complication, Nicholas Gerden, Pradip Gautam, Asad Rehman, Long Hoang

North Texas GME Research Forum 2026

Extra-intestinal infections caused by Clostridioides difficile are exceedingly rare and typically occur in settings that disrupt the gastrointestinal barrier, including recent gastrointestinal surgery, bowel perforation or microperforation, and severe colonic disease.

We present the case of a 75-year-old man with abdominal pain and hemoperitoneum in the setting of a suspected small bowel leak secondary to an intestinal mass. Computed tomography angiography revealed an 11.0 × 9.6 cm pelvic fluid collection, prompting exploratory laparotomy with drainage of a pelvic abscess and evacuation of hemoperitoneum. Intraoperatively, a small bowel perforation caused by a 4.4 cm gastrointestinal stromal tumor (GIST) was identified. Operative …

Operative Localization Of Occult Gastrointestinal Bleeding Using Intraoperative Small Bowel Endoscopy, Shuda Xia, Furrukh Jabbar, Muhammad T. Siddique

North Texas GME Research Forum 2026

No abstract provided.

Benign Hepatic Pneumatosis (Portal Venous Gas): A Case Series And Literature Review, David Ortiz, Joseph Daoudu, Mike Liang, Samin Arianpour, Nabeeha Naeem

Gulf Coast Division GME Research Day 2026

No abstract provided.

Diagnostic Complexities In Patients Presenting With Peritoneal Tuberculosis: A Case Report, Christina Mie Minami, Bailey Weidner, Tyler Mcvay

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Sudden Onset Idiopathic Necrotizing Pancreatitis Unmasking Undiagnosed Advanced Cirrhosis, Maikel Tawadrous, Mohammad Mahfouz, Aradhana Pandey, Namin Farid

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Histotripsy In Liver Tumors: A Non-Thermal, Cavitation Platform Redefining Precision Ablation And Immuno-Oncology Synergy, Subuhee Ahmed, Shahzaib Maqbool, Pradeep Rajbhandari, Mohamad Mahfouz, Maikel Tawadrous

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Multifocal Gastrointestinal Diffuse Large B-Cell Lymphoma Initially Resembling Crohn’S Disease, Mary Moussa, Durga A. Kumar, Vikas Sethi, Alvin Boyd Newman-Caro, Christopher Halleman, Michael Schulman

West Florida Division GME Research Day 2026

No abstract provided.

Rapid Diagnosis Of Hemorrhagic Shock Due To Upper Gi Bleeding With Point-Of-Care Ultrasound In The Emergency Department, Tamari Ronen, Derrick Huang

Gulf Coast Division GME Research Day 2026

No abstract provided.

Gastrointestinal Ebv In Immunosuppressed Hosts: A Case Of Ptld After Kidney Transplant, Mary Moussa, Baylen Shoemaker, Vikas Sethi, Alvin Boyd Newman-Caro, Rakhee Shah, Patricia Chun, Michael Schulman

West Florida Division GME Research Day 2026

No abstract provided.

White Plaques With High Stakes: A Case Of Esophageal Leukoplakia, Boney Lapsiwala, Ritika Sharma, Karthik Kasireddy, Devika Pavuluri, Rupali Prabhukhot, Amjad Awan

North Texas GME Research Forum 2026

Introduction: Esophageal leukoplakia, also termed esophageal epidermoid metaplasia (EEM), is a rare esophageal epithelial disorder characterized by keratinized squamous plaques on esophagogastroduodenoscopy (EGD). With a prevalence of < 0.5%, it is often incidentally identified during evaluation for nonspecific upper gastrointestinal symptoms. EEM is considered a premalignant condition due to its association with esophageal squamous cell carcinoma (SCC), yet management and surveillance strategies remain undefined.

Case Presentation: A 65-year-old woman with hypothyroidism, hypertension, hyperlipidemia, and remote aplastic anemia treated with bone marrow transplantation 35 years prior presented with chronic cough and progressive dysphagia to solids and liquids. She denied tobacco, alcohol, or illicit drug use. No weight loss, abdominal pain, or blood in stool was noted. CT of the neck with contrast revealed curvilinear mucosal hyperenhancement involving the mid to distal thoracic esophagus without lymphadenopathy. Physical examination and …

Gastroparesis As Initial Feature Of Neuromyelitis Optica Spectrum Disorder, Jasmine M. Silva, Jorim J. Parmar, Shivani Gandhi, Sreevani Gudiseva

North Texas GME Research Forum 2026

No abstract provided.

Surgical Management Of A Giant Colonic Diverticulum, Courtney Koplyay, Mason Workman, Michael Truitt, Muhammad T. Siddique

North Texas GME Research Forum 2026

INTRODUCTION: Giant colonic diverticulum (GCD), defined as a diverticulum >4 cm, is a rare manifestation of diverticular disease with less than 200 reported case reports. CT imaging is the preferred imaging modality to identify and confirm the presence of a GCD, which provides an accurate depiction of the size, location, and contents of the diverticulum GCD can present with nonspecific abdominal symptoms, abdominal pain, bloody stools, or an enlarging mass. Given the risk of serious complications, including diverticulitis, bowel obstruction, and perforation, early recognition and management are essential to prevent further complications. Surgical management with diverticulectomy or partial colectomy is …

Gastroduodenal Artery Coil Erosion Causing Pyloric Obstruction And Upper Gi Bleeding, Corey Newman, Mahad Rehman, Cody Beltran, Michael Carrick

North Texas GME Research Forum 2026

Background Trans-arterial embolization (TAE) of the gastroduodenal artery (GDA) is a well-established and effective treatment for peptic ulcer bleeding and visceral pseudoaneurysms. Although generally safe, delayed migration or erosion of embolization coils into the gastrointestinal lumen is a rare but recognized complication that may occur months to years after the procedure. Proposed mechanisms include ischemic mucosal injury, mechanical pressure from the coil mass, and chronic inflammation. Clinical manifestations vary widely, ranging from occult bleeding and ulceration to perforation or gastric-outlet obstruction. Only a limited number of cases describing GDA coil erosion presenting with both bleeding and obstruction have been reported. …

A Lethal Connection Uncovered: Direct Endoscopic Evidence Of A Primary Aortoenteric Fistula, Joel Mathews, Trina Lewis, Munazzah Kaleem, Long Hoang

North Texas GME Research Forum 2026

BACKGROUND: Primary Aortoenteric Fistulas (PAEFs) are a rare condition that occurs when the native aorta develops an abnormal connection with the gastrointestinal lumen. PAEFs tend to develop within the duodenum, specifically the distal region of the third part of the duodenum, which is retroperitoneal and is anterior to the aorta. Duodenal PAEFs can be difficult to diagnose and are often lethal, given their non-specific presenting symptoms and rapid progression to hemorrhagic shock.

CASE PRESENTATION: This case focuses on a 70-year-old male with a history of T4N2 colon adenocarcinoma with hemicolectomy, active smoking, and abdominal aortic aneurysm (AAA) who was transferred …

Esophageal Squamous Cell Carcinoma Incidentally Detected On Barium Swallow: A Case Report, Muhammad Rubeel Akram, Aditya Rao, Muhammad T. Siddique

North Texas GME Research Forum 2026

Background: Esophageal cancer is an aggressive malignancy with a poor prognosis, and has high rates of recurrence despite curative-intent therapy. While endoscopy with biopsy remains the gold standard for diagnosis, non-diagnostic imaging studies are performed when evaluating for dysphagia, and may bring to light underlying pathology, warranting further workup. Surgical resection following neoadjuvant chemoradiation is often performed, but postoperative complications and disease recurrence are important concerns. This case highlights the crucial role of early detection via imaging and the clinical burden associated with esophageal squamous cell carcinoma.

Case Presentation: A 76-year-old female presented with dysphagia and underwent a barium esophagogram, …

A Not So Typical Case Of Alcoholic Pancreatitis, Wendy Phillips, Kaleem Munazzah, Asad Rehman, Robert Keller

North Texas GME Research Forum 2026

BACKGROUND Acute pancreatitis (AP) has become one of the leading gastrointestinal diagnoses resulting in inpatient hospitalization¹. AP is diagnosed by meeting two of three criteria: characteristic clinical presentation, biochemical evidence (elevated lipase or amylase levels), and imaging findings with pancreatic inflammation. Gallstones and heavy alcohol use account for most cases (40%–70% and 25%–35%, respectively). Hypertriglyceride induced AP (HTG-AP) accounts for only about 7-10% of AP cases³ and often tends to present in younger, male, obese, patients with a higher rate of diabetes¹. Below we present a unique case of a coinciding alcoholic and HTG - AP in an otherwise healthy …

Smarca4-Deficient Carcinoma Of The Gastroesophageal Junction, Hanna Riga, Austin Lehr

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Intestinal Tuberculosis Masquerading As Crohn’S Disease: A High-Risk Diagnostic Mimic, Maikel Tawadrous, Tejaswi Vadde, Subuhee Ahmed, Lawrence San Jose, Chelsea Curry, Aradhana Pandey

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Alpha 1 Antitrypsin Deficiency In Primary Care: A Case Presentation, John Sweetman, Gazala Parvin

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

"Qt Okay, Bowel Not Okay"- Dofetilide Masking An Evolving Small-Bowel Obstruction, Tejaswini Yeshala, Pankti Shah, Syed Ali Abidi, Archana Machavarapu

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Esophageal Stents: How High Can You Go? A Traumatic Injury Treated With High Esophageal Stent Placement, John W. Surbeck, Anthony P. Melillo, James S. Scott

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

A Histopathological Mystery: A Rare Atypical Feature Of Microscopic Colitis, Mohammad Mahfouz, Pratyush Kumar, Kumar Abhishek, Archana Machavarapu

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Case Report: Spontaneous Gastric Intramural Hematoma With Intramural Dissection, Pedro De Castro, Rachel Steffes, John Surbeck, Anthony Melillo, Vince Narciso, Mohsin Soliman

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Turning Yellow On Rhythm Control: Dofetilide And The Unexpected Cholestatic Storm, Tejaswi Vadde, Mohammad Mahfouz, Prithvi Basu Roy, Subuhee Ahmed, Archana Machavarapu, Chelsea Curry

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Cologuard, Call To Action! A Structured Outreach Intervention For Patients With Unreturned Cologuard Kits, Crystal Bharat, Sophia Zia, Harsh Bhatt, Abd Almasih Barbar Askar, Kulwinder Bhatnura, Dhruv Patel, Dennis Besong

South Atlantic Division GME Research Days 2026

No abstract provided.

Robotic Assisted Duodenojejunostomy In The Treatment Of Adult Annular Pancreas, Anthony Sciuva, Denise Vera Nemeth, Riley Burgon, Noaman Ali

South Atlantic Division GME Research Days 2026

No abstract provided.

Large Mesenteric Cyst Mimicking Dyspepsia In A Young Adult Female, Arjavon Talebzadeh, Hugo Barrera

South Atlantic Division GME Research Days 2026

No abstract provided.

The Great Mimicker: Intrathecal Opioid-Induced Esophageal Dysfunction, Abhishek Desai, Lisa Persaud, Desiree Aird

South Atlantic Division GME Research Days 2026

No abstract provided.