Digestive System Diseases Commons^™

A Flare Beyond The Gut: Culture-Negative Skin Abscesses In Ulcerative Colitis, Jose J. Loayza Pintado, Mohammad Aqeel, Jorge Aboytes Trevino, Taiwo Ajani, Andres Suarez

Research Symposium

Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease often complicated by extraintestinal manifestations, with skin involvement seen in up to 15% of patients. Typical lesions include erythema nodosum and pyoderma gangrenosum, but abscess-like cutaneous lesions are almost always assumed to be infectious. Rare case reports describe sterile, culture-negative abscesses arising during UC flares, yet their true prevalence is unknown. We present the case of a young man with UC who developed multiple aseptic skin abscesses in parallel with active proctitis.

Case Presentation: A 19-year-old man with prior Clostridioides difficile infection and subtotal colectomy (rectal preservation) presented with malaise, …

An Unusual Case Of Spontaneous Bacterial Peritonitis Due To Weissella Cibaria In A Patient With Decompensated Cirrhosis, Janetly Reinoso, Felipe Diaz Jr, Jose E. Campo Maldonado

Research Colloquium

Background: Spontaneous bacterial peritonitis (SBP) is a serious infection commonly encountered in patients with decompensated cirrhosis and ascites, usually involving gram-negative organisms. Weissella cibaria is a gram-positive, catalase-negative, facultative anaerobe not typically associated with intra-abdominal infections. This case report highlights an unusual instance of SBP caused by W. cibaria in a cirrhotic patient, emphasizing the clinical importance of identifying atypical organisms and discussing implications for antimicrobial stewardship in vulnerable populations.

Case Presentation: A 65-year-old woman with decompensated nonalcoholic steatohepatitis (NASH) cirrhosis status post-transjugular intrahepatic portosystemic shunt (TIPS) placement and recurrent ascites requiring weekly paracentesis presented with altered mental status following …

A Case Of Microscopic Colitis Masquerading As Chronic Inflammatory Diarrhea, Corey Haines, Sophia Moon, Giani Tah, Diana Acosta Pozo, Alejandro Aquino, Fatimah Bello

Research Symposium

Introduction: Microscopic colitis is an idiopathic, inflammatory form of colitis that is characterized by a normal macroscopic appearance of bowel but abnormal histological appearance on microscopy. Microscopic colitis can be subdivided into two histological subtypes: collagenous and lymphocytic. The collagenous subtype is characterized by proliferation of collagenous connective tissue that forms a thick subepithelial collagen band while the lymphocytic subtype is characterized by lymphocytic infiltrates and little to no proliferation of connective tissue. Classically, microscopic colitis presents with chronic, nonbloody, watery diarrhea lasting more than one month. It is typically associated with weight loss, abdominal pain, tenesmus, and nocturnal stools. …

Targeting Ribosome Biogenesis Is A Novel Approach For The Management Of Pancreatic Cancer, Mudassier Ahmad, Haider Ahsan, Carlos Perez, Muhammad Bangash, Andrew Massey, Emmanuel Anning, Manish Tripathi, Dae Kim, Subhash C. Chauhan, Bilal Bin Hafeez

Research Colloquium

Pancreatic ductal adenocarcinoma is the third leading cause of cancer-related deaths in the United States with limited therapeutic options available. Gemcitabine, a deoxycytidine nucleoside analog is currently considered the most effective therapy for PanCa. However, it shows only a marginal survival benefit of six months. Aberrant ribosome biogenesis occurs in most tumor types. We observed that PanCa cells are addicted to ribosome biogenesis, which supports their highly aggressive metastatic phenotypes. Thus, strategically targeting ribosome biogenesis process could be one of the ideal strategies for the prevention and treatment of PanCa. In this study, we elucidated the molecular mechanisms of POLR1A …

Concurrent Challenges: New-Onset Type 2 Diabetes And Invasive Pancreatic Adenocarcinoma: A Case Report, Abhishekh Pokhrel, Alexa Lissete Zarate, Sobia Hassan Memon, Everardo Cobos

Research Colloquium

Background: Pancreatic adenocarcinoma is a highly aggressive cancer with a five-year survival rate of about 10%, and is the third leading cause of cancer-related deaths in the United States. Approximately 53% of patients are diagnosed at stage IV, characterized by distant metastasis to common sites such as the liver and lungs. Liver metastases occur in 60-70% of metastatic cases, while lung metastases are seen in 10-15% of patients. The median survival for stage IV patients is typically around 3 to 6 months, with current treatments primarily focused on palliation. Advances in chemotherapy offer modest survival benefits, but early detection and …

Unexpected Biliary Duct Dilation, A Wise Decision-Making Case., Mario A. Trujillo, Mathew R. Peynado, Muhammad Ali Siddiqui, Laura P. Ackerman

Research Colloquium

Background: Common bile duct dilation is expected in certain healthy populations with specific factors like age or post procedure status. When a size larger than expected is found in an acute setting further investigation is required. In the setting of acute abdominal pain in a patient with past medical history of cholelithiasis, the study protocol for patients with more than expected enlarged common bile duct and no apparently underlying disease in the biliary tree is not well elucidated.

Case: A 68-year-old female with past medical history but not limited to cholelithiasis, hypertension, type 2 diabetes mellitus, end stage renal …

Honey: A Natural Recipe For The Management Of Pancreatic Cancer, Aun A. Bangash, Muhammad A. Bangash, Georgina Villanueva, Haider Ahsan, Shiza Khan, Rida Shareef, Mudassier Ahmad, Dae J. Kim, Sahir S. Alvi, Bilal B. Hafeez

Research Colloquium

Background: Pancreatic cancer (PanCa) is the fourth deadliest cancer worldwide and expected to become the second deadliest cancer by 2030. In the USA, the National Cancer Institute put forth a grim prediction stating that there will be 64,050 new cases in 2023 alone and about 50,000 of these patients will die. The first line treatment for pancreatic cancer is Folfrinox, a three-drug regimen consisting of 5-Fluorouracil, irinotecan, and oxaliplatin. The second line treatment is gemcitabine combined with paclitaxel. Only 19% of patients who are prescribed the former regimen survive past 18 months of treatment while just 6% of patients survive …

Significance Of Targeting Rna Polymerase I In Intrahepatic Cholangiocarcinoma, Muhammad A. Bangash, Aun A. Bangash, Haider Ahsan, Sahir Alvi, Mudassier Ahmad, Alejandro Rincon, Samuel Owusu-Mireku, Bilal Hafeez

MEDI 9331 Scholarly Activities Clinical Years

Intrahepatic cholangiocarcinoma (IHCC) is a much-overlooked cancer with a mortality rate that has increased throughout recent years, as stated by the American Cancer Society [1]. In the United States alone, there are an estimated 8,000 adults being diagnosed with IHCC every year, with a five-year survival rate of 9% [2]. Chemotherapy options for the treatment of IHCC include systemic chemotherapy such as gemcitabine, capecitabine, and oxaliplatin. These medications carry a wide array of adverse factors that may warrant discontinuation due to the detriment to the well-being of the patient. Additionally, a broad field of therapy that may also be used, …

Prevalence Of Liver Cirrhosis And Its Association With Obesity Among Mexican Americans: An Evidence Synthesis, Alexa Perlick, Abaigeal Thompson, Colton Wayne, Angel Rendon, Jose E. Campo Maldonado

Research Colloquium

Introduction: Chronic liver disease is the 6^th and 7^th leading cause of death in Hispanic men and Hispanics, respectively.¹ In contrast to other causes of liver disease, the prevalence of nonalcoholic liver disease has been growing as is diabetes and obesity.²

Objective: There is a paucity of data regarding the prevalence of cirrhosis for Mexican Americans in South Texas. The aim of this evidence synthesis is to investigate the prevalence of cirrhosis in Hispanic populations and its relationship with obesity.

Methods: PubMed was used to perform a thorough literature search on September10, 2020. The terms “liver …

It Takes A Big Heart To Shape Atrophic Hepatocytes: Hypoxic Hepatitis Secondary To Congestive Heart Failure, Lina Pedraza Sanchez, Jose Rivera, Cynthia Rivas, Grigoriy Rapoport, Michelle Lopez

Research Colloquium

Introduction: Hypoxic hepatitis (HH) also known as ischemic hepatitis is the result of a hypoperfusion state during diffuse hepatic injury¹. The incidence of HH is 2:1000 of patients within any hospital care level. 94% of HH are related to chronic heart failure (HF). In this setting, hepatic dysfunction occurs as a result of passive venous congestion². The most common predisposing factors are acute heart failure and shock states, however, more than half of the cases are not related to any hemodynamic change, thus, underrecognized.

Case description: A 77-year-old woman is admitted to the hospital for acute …

An Unusual Case Of Chronic Superior Mesenteric Vein Thrombosis, Ans Albustamy, Eric Sanchez, Oscar Lopez, Schamma Salomon

Research Symposium

Introduction:Intestinal ischemia can be caused by any process that reduces intestinal blood flow. Mesenteric venous thrombosis (MVT) describes thrombosis of the superior or inferior mesenteric vein, and represents approximately 10 percent of all cases of acute mesenteric ischemia. The incidence of MVT has increased over the past 40 years, likely as a result of greater use of abdominal CT, and may present with acute abdominal pain or as an asymptomatic incidental finding on abdominal imaging. We present a rare and unusual case of MVT.

Case presentation: A 42 year old female with decompensated alcoholic liver cirrhosis presented to the …

A Stomach Bug? Not What You May Think: A Case Of Post-Viral Gastroparesis Caused By Sars-Cov-2, Adrienne Anderson, Nina Shyama Appareddy, Jose Ramos, Grecia Dominguez Rivera, Robinson Pena, Jose E. Campo Maldonado

Research Symposium

Gastroparesis has a wide range of etiologies including diabetes, medications, post-surgical, post-viral and idiopathic (1). SARS-CoV-2 can cause gastrointestinal symptoms which typically resolve within the first few weeks of infection (2). However, some sequelae persist beyond the initial infectious period.

A Comparison Of The Prevalence Of Cirrhosis In A Hispanic And Non-Hispanic Population Based On Body Mass Index, Alexa Perlick, Abaigeal Thompson, Colton Wayne, Jose Campo Maldonado, Angel Rendon

MEDI 9331 Scholarly Activities Clinical Years

Background and Significance

The obesity epidemic is a growing public health concern. In addition to the already known complications and comorbidities associated with obesity, data suggest that obesity is an independent risk factor for the development of liver disease. ^1,2 However, there is a paucity of data regarding the clinical correlation of obesity and cirrhosis in a predominantly Hispanic population. Therefore, the aim of this study is to investigate the prevalence of cirrhosis stratified by BMI in a predominately Hispanic population.

Materials and Methods

This retrospective single-centered study was approved by the University of Texas Rio Grande Valley institutional ethics …