Digestive System Diseases Commons^™

Comparing The Ppv Of At-Home Screening Tests With Chronic Anticoagulant And/Or Antiplatelet Therapies, Bradley Gustafson, Nasima Mehraban, Amjad Awan, Michele Mccarroll

North Texas GME Research Forum 2024

BACKGROUND: With the rising incidence and mortality of colorectal cancer (CRC), early diagnosis and treatment is imperative. At-home CRC screening kits are a non-invasive Federal Drug Association (FDA) approved designed to detects either hemoglobin or DNA markers associated for CRC and high-grade polyps. Therefore, therapies that have a propensity to increase rates of gastrointestinal bleeding could theoretically lead to higher false positive rates. The goal of this study was to determine the positive predictive value of at-home screening tests when applied to patients on therapies such as antiplatelet, anticoagulant, non-steroidal anti-inflammatory (NSAID), or a combination of the three. METHODS: The …

Multidisciplinary Management For Large And Difficult Choledocholithiasis: The Role Of Choledochotomy, Jilpa Shah, Balu Chandra

North Texas GME Research Forum 2024

Extracranial carotid artery aneurysm is a rare sequela of atherosclerosis, trauma, and conditions of chronic inflammation. Standard treatments include antiplatelet medications, open resection, or endovascular stenting. Transcarotid artery revascularization (TCAR) has become a well-recognized alternative treatment in the past few decades. This case study documents the first reported case of Horner’s syndrome post-TCAR for an internal carotid artery (ICA) aneurysm. A 68 year-old male with intermittent double vision was referred to vascular surgery clinic with brain CT angiography showing a 9mm saccular aneurysm with dissection flap of the right cervical ICA. Prior attempts by neuro-interventional radiology were unsuccessful due to …

Gut Fermentation Syndrome: Unraveling The Enigma Of Auto-Brewery Syndrome., Jatin Sadarangani, Vaishnavi Singh, Sathish Karmegam

North Texas GME Research Forum 2024

A disorder known as "auto-brewery syndrome" or "gut fermentation syndrome" occurs when bacteria or fungus in the urinary, oral, or gastrointestinal tract ferment endogenously, producing ethanol. Patients with auto-brewery syndrome frequently report eating a diet heavy in sugar and carbohydrates and exhibit many of the symptoms and indicators of alcohol intoxication while disputing alcohol consumption. Research on Nonalcoholic Fatty Liver Disease indicates that endogenous alcohol synthesis may have bacterial roots; these bacteria may also be the causative agents in GFS. Probiotics, low-carb diets, anti-fungal medications, and antibiotics are currently used as therapies for GFS. Fecal microbiota transplantation may also have …

Mast Cell Colitis Associated With Yersinia Enterocolitica, Olufemi Osikoya, Gregory Brennan

North Texas GME Research Forum 2024

Introduction: Mast cells (MCs) have many functions including regulation of GI epithelial homeostasis, cross talk of the brain gut axis, host immune defenses, and inflammatory pathways. MCs are found in all layers of the GI tract and have been implicated in various gastrointestinal diseases. Although previously described in the literature, mast cell colitis is not considered a distinct clinical entity. This poses a challenge to the gastroenterologist who encounters such pathologic findings. Case Presentation: This is a case of a 76-year-old woman who was referred to the gastroenterology clinic for evaluation of a new diagnosis of colitis. The patient …

Colon Cancer Symptom Progression In A Non-Adherent Patient: A Case Report, Nasima Mehraban, Bradley Gustafson, Saad Hussain, Amjad Awan

North Texas GME Research Forum 2024

BACKGROUND: Colorectal cancer (CRC) is the second leading cause of cancer mortality and third leading cause of incidence worldwide; accounting for one in ten cancer cases and deaths. Thirty-three percent of people between the age of 50 and 75 are not up to date on screening for colon cancer. Depending on the stage of CRC at the time of presentation, the range of chief complaints that bring patients to seek care for this single etiology is diverse, therefore, a thorough work-up is essential for diagnosis. CASE PRESENTATION: A 55-year-old patient presents to the hospital three times over the course …

Rare Rectal Lipoma Case Report, Victoria Nguyen, Sean Sojdie, Kunal Elete, Justin Richardson, Long Hoang

North Texas GME Research Forum 2024

INTRODUCTION: Colonic lipomas are rare, benign non-epithelial lesions of the gastrointestinal (GI) tract that predominantly affect elderly females and often found in the ascending colon. They are least common in the rectum, with a prevalence of 3.4%. Lipomas can grow to cause abdominal pain, bleeding, or obstruction. We report an incidental finding of a rectal lipoma in a patient presented with rectal bleeding. CASE: A 70 year-old male with a history of migraines presented to the hospital for two weeks of rectal bleeding and syncopal episode prior to arrival. Patient had visited the emergency department two weeks prior, but hemoglobin …

The Role Of Ercp In Post Covid-19 Cholangiopathy: A Systemic Review Of Published Case Reports, Olufemi Osikoya, Gregory Brennan

North Texas GME Research Forum 2024

Introduction: Post COVID-19 cholangiopathy (CC) is a rare complication of COVID-19 infection. It is characterized by abnormal elevation of serum alkaline phosphatase, with evidence of bile duct injury (via imaging or biopsy) in the absence of other causes. Not much is known regarding the role of ERCP in post COVID-19 cholangiopathy. We sought to better understand the findings, interventions and outcomes in patients with CC undergoing ERCP. Methods: We searched Pubmed, Scopus and Embase from December 2019 to present. Search words included "post-Covid-19 cholangiopathy," and “ERCP.” Data on patient characteristics, COVID-19 infection, imaging, ERCP fluoroscopic findings, ERCP interventions, …

Primary Resection Of Duodenal Neuroendocrine Tumor With Suspected Lymph Node Metastasis: A Case Report, Raleigh Payton, David Bassa, Furrukh Jabbar, Hassan Ahmed

North Texas GME Research Forum 2024

Introduction: Duodenal neuroendocrine carcinomas are an uncommon variant of Neuroendocrine tumors (NETs) that are typically non-functional with locoregional spread at the time of diagnosis. Management of these tumors is dependent on size, grade, stage, functional status and location.

Summary: A 66-year-old male presented with an incidental finding of low grade 3 centimeter duodenal NET on esophagogastroduodenoscopy (EGD) located in the second segment of the duodenum with evidence of lymphadenopathy on staging scans. In patients with suspected lymph node metastases, the first choice for curative intent is a pancreaticoduodenectomy (PD), also known as Whipple Procedure. We achieved surgical resection with free …