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Full-Text Articles in Digestive System Diseases

Gallbladder Ascariasis Presenting As Acalculous Biliary Colic, Carmen A. Urbina, Luigi G. Cubeddu, Luigi X. Cubeddu Aug 2026

Gallbladder Ascariasis Presenting As Acalculous Biliary Colic, Carmen A. Urbina, Luigi G. Cubeddu, Luigi X. Cubeddu

HCA Healthcare Journal of Medicine

We detail a case of gallbladder ascariasis, presenting as an acute episode of acalculous biliary colic, nausea, bloating, an unremarkable abdominal ultrasound, and negative helminth and protozoa stool smears. A follow-up ultrasound provided unexpected images consistent with gallbladder infection by Ascaris lumbricoides. Repeat ultrasonography performed 10 days after anthelmintic therapy showed no live worms and 2 newly appearing echogenic areas suggestive of gallbladder calculi that were confirmed following elective cholecystectomy. The case course highlights key clinical, diagnostic, and management considerations in gallbladder ascariasis and underscores the value of repeated ultrasonographic evaluation in affected patients.


Psychological Adaptation In Colorectal Cancer Survivors: Pilot Study Findings, Anuja L. Sarode, Emily M. Su, Amber Kerstetter-Fogle, Steve Paciorek, Erica L. Laipply Aug 2026

Psychological Adaptation In Colorectal Cancer Survivors: Pilot Study Findings, Anuja L. Sarode, Emily M. Su, Amber Kerstetter-Fogle, Steve Paciorek, Erica L. Laipply

HCA Healthcare Journal of Medicine

Background

In this pilot study, we examined psychological impacts of colorectal cancer (CRC), focusing on cancer-related posttraumatic stress disorder (CR-PTSD) symptoms, posttraumatic growth (PTG), and their relationship with coping strategies in surgically treated CRC patients.

Methods

This prospective pre- and postoperative pilot study assessed CRC patients at 2 time points, pre- and postoperative. Psychological symptoms were evaluated using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) and the PTG Inventory Short Form (PTGI-SF). Coping strategies were assessed using the Brief Coping Orientation to Problems Experienced (COPE) instrument. Changes in CR-PTSD, PTG, and coping …


Coping Beyond Cancer: Exploring Fear Of Recurrence In Colorectal Cancer Survivors—A Pilot Investigation, Emily M. Su, Steve Paciorek, Erica L. Laipply, Anuja L. Sarode Aug 2026

Coping Beyond Cancer: Exploring Fear Of Recurrence In Colorectal Cancer Survivors—A Pilot Investigation, Emily M. Su, Steve Paciorek, Erica L. Laipply, Anuja L. Sarode

HCA Healthcare Journal of Medicine

Background

Evidence is limited on the fear of cancer recurrence (FCR) among colorectal cancer (CRC) survivors in the US, especially regarding patterns and trends of post-recovery coping mechanisms. This pilot mixed-methods study quantified FCR, examined its associations with Brief COPE domains, and contextualized coping through qualitative analysis.

Methods

Twenty-three patients who successfully underwent CRC surgery were included in this pilot study. Fear of cancer recurrence was measured using the FCR Inventory (FCRI) Short Form, and coping strategies were assessed with the Brief Coping Orientation to Problems Experienced (COPE) survey. Descriptive statistics summarized participant characteristics, FCR, and COPE scores. Spearman correlation …


The Effect Of Empiric Initiation Of Treatment On Outcomes Among Patients Presenting With Extrapulmonary Mycobacterium Tuberculosis Infection In A Community Hospital Setting, Talha Awwal, Faisal Raja Kh, Hanya Awaba, Waseem Anwar, Jinma Ren, Muhammad Aamir Safdar, Saqib Walayat, John J. Farrell Jul 2026

The Effect Of Empiric Initiation Of Treatment On Outcomes Among Patients Presenting With Extrapulmonary Mycobacterium Tuberculosis Infection In A Community Hospital Setting, Talha Awwal, Faisal Raja Kh, Hanya Awaba, Waseem Anwar, Jinma Ren, Muhammad Aamir Safdar, Saqib Walayat, John J. Farrell

Journal of Community Hospital Internal Medicine Perspectives

Background: Extrapulmonary tuberculosis (EPTB) accounts for ~20% of Mycobacterium tuberculosis infections in Pakistan. Diagnostic delays are common and may worsen outcomes. We evaluated whether empiric treatment initiation improves outcomes among patients with EPTB at a large public hospital in Islamabad, Pakistan. Methods: Retrospective cohort of consecutive EPTB cases at Pakistan Institute of Medical Sciences (January–June 2016). Patients were categorized as clinically diagnosed (symptoms/radiology) or laboratory-supported (histology, microbiology, or biochemical tests). Standard Directly Observed Therapy Short-course (DOTS) based regimens were used. Outcomes were treatment success, failure, loss to follow-up, and mortality; groups were compared using chi-square testing. Results: Of 317 EPTB …


Navigating Complex Esophageal Perforations: A Case-Specific Approach To Successful Outcomes, Harsimran Kalsi, Anushree Rai, Kobina Essilfie-Quaye, Neeka Akhavan, Yaseen Perbtani, Tony S. Brar Jun 2026

Navigating Complex Esophageal Perforations: A Case-Specific Approach To Successful Outcomes, Harsimran Kalsi, Anushree Rai, Kobina Essilfie-Quaye, Neeka Akhavan, Yaseen Perbtani, Tony S. Brar

HCA Healthcare Journal of Medicine

Esophageal perforation is a life-threatening condition requiring prompt diagnosis and effective management. While self-expanding metal stents (SEMS) are a first-line treatment, persistent leaks often necessitate adjunctive endoscopic interventions. A structured, multimodal approach is critical for optimizing outcomes and avoiding surgical intervention. A 44-year-old man developed an iatrogenic esophageal perforation following surgical leiomyoma enucleation. Initial treatment with overlapping fully covered self-expanding metal stents (FC-SEMS) failed to achieve closure, necessitating endoscopic suturing for defect reinforcement. Despite suturing, persistent leakage required placement of a larger-diameter FC-SEMS, secured with an endoscopic fixation system to prevent migration. Serial imaging confirmed successful defect closure, allowing the …


Investigating Corollaries Between Streptococcus Gallolyticus Subsp. Gallolyticus Virulence And Colorectal Cancer, Tyler G. Myers Mar 2026

Investigating Corollaries Between Streptococcus Gallolyticus Subsp. Gallolyticus Virulence And Colorectal Cancer, Tyler G. Myers

Pursuit - The Journal of Undergraduate Research at The University of Tennessee

Streptococcus gallolyticus subsp. gallolyticus (Sgg) is a gram-positive, non-beta-hemolytic bacterium that belongs to the Lancefield group D of streptococcal pathogens. For the past several decades, associations between Sgg bacteremia and colorectal cancer (CRC) have been apparent, with gastroenterologists routinely recommending colonoscopies for positive cases of Sgg in either blood or stool samples. However, current research has not wholly established whether Sgg acts as a causative agent of CRC or if pre-existing cancers make the lumen of the colon more hospitable to its colonization. Regardless, Sgg has been implicated in the modulation of host inflammatory pathways and subsequent remodeling …


A Blood-Based Test For Colorectal Cancer Screening, Joshua Cullison Dec 2025

A Blood-Based Test For Colorectal Cancer Screening, Joshua Cullison

HCA Healthcare Journal of Medicine

Within the United States (US), colorectal cancer (CRC) remains the fourth most common malignancy and is responsible for over 50 000 deaths annually, second only to lung cancer in cancer mortality. Despite increased public awareness and increasing screening rates, the US remains far below the 80% screening mark set by the National Colorectal Cancer Roundtable at 59%. The addition of non-invasive blood-based tests for CRC screening could potentially increase screening rates and lower CRC deaths.

I performed a PubMed search using the search term “blood-based colorectal cancer screening.” I was particularly interested in articles that looked at Shield, which is …


The Top Twenty-Five Most Influential Articles In Surgery For Colorectal Cancer, Dana Poloni, Andrew Anklowitz, Fred Kobylarz, Christina Monaco Poloni, Ankit Dhiman, Pamela Burgess, Andrew Schlussel Dec 2025

The Top Twenty-Five Most Influential Articles In Surgery For Colorectal Cancer, Dana Poloni, Andrew Anklowitz, Fred Kobylarz, Christina Monaco Poloni, Ankit Dhiman, Pamela Burgess, Andrew Schlussel

HCA Healthcare Journal of Medicine

Background

This article provides surgical trainees with a ranked list of the foundational literature that guides the contemporary surgical management of colorectal cancer and shows the evolution of surgical techniques in the field.

Methods

We assessed the surgical literature using the Web of Science and other ranking systems to create a ranked list of published articles on colorectal cancer surgery.

Results

We compiled a ranked list of the top 25 articles in the surgical management of colorectal cancer, based on the citation density score (mean number of citations per year) and the individual author H-index. The mean density score of …


Application Of Flexible Endoscopy For Gastrointestinal Foreign Body Removal In A Leopard Gecko (Eublepharis Macularius), Jang-Hee Han, Seung Yoon Ahn, Do Na Lee, Seong Chan Yeon Dec 2025

Application Of Flexible Endoscopy For Gastrointestinal Foreign Body Removal In A Leopard Gecko (Eublepharis Macularius), Jang-Hee Han, Seung Yoon Ahn, Do Na Lee, Seong Chan Yeon

The Thai Journal of Veterinary Medicine

A male captive-bred leopard gecko (Eublepharis macularius) presented with a history of inadvertent ingestion of a rubber tip from forceps during feeding. The foreign body was impalpable on physical examination, while radiographic evaluation confirmed its presence in the stomach. Considering the procedural risks associated with invasive surgical interventions, endoscopic retrieval under general anesthesia was pursued. An initial attempt using a 2.8 mm superfine flexible endoscope with 0.8 mm forceps was unsuccessful due to insufficient stability, which hindered effective navigation to the foreign body. In contrast, a second attempt using a larger 9.2 mm flexible endoscope with 2.3 mm …


Risk Factors Of Acute Gastroenteritis And The Implementation Of Community-Based Total Sanitation In Banyuwangi, Indonesia: A Cross-Sectional Study, Citra Al Karina, Juniastuti Juniastuti, Budi Utomo, I Made Dwi Mertha Adnyana Aug 2025

Risk Factors Of Acute Gastroenteritis And The Implementation Of Community-Based Total Sanitation In Banyuwangi, Indonesia: A Cross-Sectional Study, Citra Al Karina, Juniastuti Juniastuti, Budi Utomo, I Made Dwi Mertha Adnyana

Makara Journal of Health Research

Background: In Banyuwangi Regency, Indonesia, diarrhea remains a major health problem, even though the community-based total sanitation (CBTS) program has been implemented for ten years. This household survey study aimed to identify the risk factors of acute gastroenteritis (AGE) and to evaluate the implementation of CBTS in Banyuwangi Regency.

Methods: A cross-sectional study was conducted in Banyuwangi Regency. Characteristic data from patients with AGE were collected from the two primary healthcare working areas, followed by collecting data of their family members and CBTS in their houses. Data were obtained through interviews and direct observation. The CBTS evaluation results …


A Hard Problem: Managing Constipation In The Geriatric Population, William G. Jones, Veeraen Jonnalagadda, Alexandra E. Thomson, Victoria Grumbles, Chase Cottle, Christian Robertson, Maulikkumar Patel Aug 2025

A Hard Problem: Managing Constipation In The Geriatric Population, William G. Jones, Veeraen Jonnalagadda, Alexandra E. Thomson, Victoria Grumbles, Chase Cottle, Christian Robertson, Maulikkumar Patel

HCA Healthcare Journal of Medicine

Constipation is a common condition among geriatric patients with different presenting symptoms and potential serious complications. Additionally, the condition causes a significant burden on our healthcare system. Here, we summarized recommendations from several societies, including the American College of Gastroenterology, American Geriatrics Society, and American Academy of Family Physicians to provide guidance on managing constipation with geriatric patients. Our aim was to emphasize the importance of prevention of constipation in this population and methods to do so. We also give recommendations on how to manage constipation when it does develop and how to manage it across different healthcare settings. These …


The Diagnostic Maze: Challenges In Autoimmune Hepatitis Lab Interpretation, Tina C. L. Phan, Esther Blondeau-Lecomte, Christopher D. Jackson Jul 2025

The Diagnostic Maze: Challenges In Autoimmune Hepatitis Lab Interpretation, Tina C. L. Phan, Esther Blondeau-Lecomte, Christopher D. Jackson

Journal of Community Hospital Internal Medicine Perspectives

Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease characterized by the presence of circulating autoantibodies. The spectrum of disease manifestations extends from asymptomatic cases to mild symptoms and, in rare instances, acute liver failure. AIH is a diagnosis of exclusion, supported by the detection of autoantibodies such as anti-smooth-muscle antibody (ASMA). This case describes a 43-year-old female with myasthenia gravis, receiving monthly intravenous immunoglobulin (IVIG) infusions, who presented with persistently elevated liver enzymes and mildly elevated ASMA titers across multiple clinical encounters. A liver biopsy revealed severe acute hepatitis. While drug-induced liver injury (DILI) secondary to IVIG was initially …


Distribusi Kejadian Diare Pada Balita Dan Kualitas Sumber Air Minum Di Indonesia: Studi Ekologi, Nadia Z. Sabira, Naijla I. Shaliha, Sandrina H. Salsabila, Wellsa D. Kusumaningrum Jun 2025

Distribusi Kejadian Diare Pada Balita Dan Kualitas Sumber Air Minum Di Indonesia: Studi Ekologi, Nadia Z. Sabira, Naijla I. Shaliha, Sandrina H. Salsabila, Wellsa D. Kusumaningrum

Jurnal Nasional Kesehatan Lingkungan Global

Background: Diarrhea is an infectious disease with the third highest mortality rate in children under 5 years of age globally. The Indonesian Ministry of Health states that 88% of deaths from diarrhea in children are caused by poor sanitation practices and inadequate quality of drinking water sources. This study aims to describe the distribution of the quality of drinking water sources and the prevalence of diarrhea in all provinces in Indonesia. Methods: This study used an ecological study approach with secondary aggregate data from Survei Kesehatan Indonesia (SKI) 2023 and Studi Kualitas Air Minum Rumah Tangga (SKAM RT) 2020. The …


Unraveling The Mystery: A Case Study On Eosinophilic Esophagitis, Echo Kopplin Jun 2025

Unraveling The Mystery: A Case Study On Eosinophilic Esophagitis, Echo Kopplin

Lynchburg Journal of Medical Science

The incidence of Eosinophilic Esophagitis (EoE) has dramatically increased in the last two decades. This article reviews the presentation, diagnosis, and treatment of EoE, enhancing clinician awareness and recognition of the condition.


Intermittent Fasting For Metabolic Syndrome Management, Tony Laborde Jun 2025

Intermittent Fasting For Metabolic Syndrome Management, Tony Laborde

Lynchburg Journal of Medical Science

This paper reviews the potential of intermittent fasting as a non-pharmacological therapeutic approach to the treatment of metabolic syndrome (MetS). MetS is a global health problem with risk factors that include obesity, hypertension, hyperglycemia, low high-density lipoprotein (HDL) cholesterol, and high triglycerides that predispose to cardiovascular disease and type 2 diabetes. Traditional treatment approaches, including pharmacological agents and lifestyle modification, are typically of short-term benefit. Intermittent fasting, with its scheduled cycles of eating and fasting, presents another strategy for improving weight control, insulin sensitivity, lipid profiles, and blood pressure. Various intermittent fasting regimens, including time-restricted feeding and alternate-day fasting, have …


Epidemiology Of Acute Infectious Diarrhea-Associated Viruses In Children In Hangzhou, China, 2023, Ya-Jun Guo, Lin Li, Qin-Rui Lai, Wei Li Jun 2025

Epidemiology Of Acute Infectious Diarrhea-Associated Viruses In Children In Hangzhou, China, 2023, Ya-Jun Guo, Lin Li, Qin-Rui Lai, Wei Li

Journal of Pediatric Infectious Diseases

Objective: To investigate the epidemiological characteristics of children infected with diarrheal virus in Hangzhou, China, 2023.

Methods: From January 2023 to December 2023, 20,939 stool samples from children with acute infectious diarrhea were collected for detection of rotavirus A and human adenovirus, using Latex agglutination detection kits; 7584 stool samples were collected for detection of norovirus, using real‐time PCR reagent.

Results: 639 (3.0%, 639/20,939) tested positive for rotavirus A, and 1,201 (5.7%, 1,201/20,939) positive samples were detected by Colloidal gold method. The positive rates of norovirus were 42.2% (3,203/7,585). Among all age groups, the rotavirus A positive detection rate was …


A ‘Fluke’ Diagnosis: Suspecting Fascioliasis As A Rare Cause Of Hepatic Abscess, Tharun Shyam, Rosa Lora, Sharanya Kaushik, Jessica Chung, Monica Ghitan, Christina Coyle May 2025

A ‘Fluke’ Diagnosis: Suspecting Fascioliasis As A Rare Cause Of Hepatic Abscess, Tharun Shyam, Rosa Lora, Sharanya Kaushik, Jessica Chung, Monica Ghitan, Christina Coyle

Journal of Community Hospital Internal Medicine Perspectives

Hepatic abscess is a rare complication of fascioliasis, with fewer than 50 reported cases worldwide. The diagnosis requires a high degree of suspicion and is often identified after extensive investigation leading to delays in treatment. With this case report, we aim to highlight the need for a higher index of suspicion in non endemic regions like the USA, especially in cities with large immigrant populations. Given the ease and success rates of treatment with oral triclabendazole, the morbidity from unnecessary invasive testing and disease burden is preventable with a thorough evaluation and targeted clinical assessment.


Terlipressin-Induced Hyponatremic Seizures In A Patient With Congenital Hepatic Fibrosis, Luca Gauci, Jorge Gafa, Suzanne Cauchi, Jurgen Gerada Feb 2025

Terlipressin-Induced Hyponatremic Seizures In A Patient With Congenital Hepatic Fibrosis, Luca Gauci, Jorge Gafa, Suzanne Cauchi, Jurgen Gerada

HCA Healthcare Journal of Medicine

Introduction

Acute variceal bleeding from portal hypertension is one of the most serious complications with a mortality rate of 15% to 25%. Terlipressin is a vasopressor that controls variceal bleeding by lowering the portal pressure and reducing blood flow to the varices.

Case Presentation

We report a case of a patient with acute variceal bleeding, treated endoscopically and with terlipressin, who developed severe hyponatremia and seizures requiring admission to intensive care. Clinical and biochemical improvements were noticeable upon the cessation of terlipressin, with an eventual discharge from the hospital.

Conclusion

Prompt management of acute variceal bleeding with both endoscopic and …


Could Sigmoid Diverticulitis, Drug-Induced Liver Injury, And Drug-Induced Pancreatitis Co-Occur?, Rutwik Pradeep Sharma, Ryan Tam, Michael Labuzetta, Richard Alweis Nov 2024

Could Sigmoid Diverticulitis, Drug-Induced Liver Injury, And Drug-Induced Pancreatitis Co-Occur?, Rutwik Pradeep Sharma, Ryan Tam, Michael Labuzetta, Richard Alweis

Advances in Clinical Medical Research and Healthcare Delivery

Sigmoid diverticulitis is a leading cause of gastrointestinal pathology etiology, which causes hospital admissions in Western society. Recent studies have shown its prevalence to be 1-4%. Drug-induced liver injury (DILI) is a primary cause of acute liver failure in the West. The incidence of DILI is between 14-19 cases per 100,000 population. The prevalence of drug-induced pancreatitis (DIP) is 2-5%, although this is hard to estimate given the lack of large-scale studies. Sulfasalazine is a disease-modifying antirheumatic drug that is indicated for the treatment of chronic inflammatory diseases such as rheumatoid arthritis and ulcerative colitis. It has been associated …


Prevalence Of Serious Diagnoses And Disposition Among Older Adults Presenting With A Chief Complaint Of Constipation, A Retrospective Repeated Cross-Sectional Study, Ari B. Friedman, Michael N. Adjei-Poku, Rachel Gonzales, Rachel Kelz, Rachel R. Wu, Anne R. Cappola Nov 2024

Prevalence Of Serious Diagnoses And Disposition Among Older Adults Presenting With A Chief Complaint Of Constipation, A Retrospective Repeated Cross-Sectional Study, Ari B. Friedman, Michael N. Adjei-Poku, Rachel Gonzales, Rachel Kelz, Rachel R. Wu, Anne R. Cappola

Journal of Geriatric Emergency Medicine

A chief complaint of “constipation” in the emergency department (ED) is generally considered low-risk, and potentially suitable for lower acuity care. However, it may also indicate abdominal pain perceived as lower severity by triage staff, despite being relatively high-risk. We hypothesized that ED visits for constipation in older adults would more frequently result in the diagnosis of serious, treatable conditions compared to younger adults. We analyzed data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) over an 8-year period (2013-2020). Older adults with constipation were more likely to be non-Hispanic White. Among adults with constipation, 25.6% (95% CI: 22.8-28.4) …


Preventive Effects Of Quercetin On The Leaky Gut By Suppression Of Il-1beta-Induced Transcription Factors Involved In An Inflammatory Pathway In Colonic Epithelial Cells, Wannaporn Chayalak, Sumpun Thammacharoen, Chatsri Deachapunya, Sutthasinee Poonyachoti Aug 2024

Preventive Effects Of Quercetin On The Leaky Gut By Suppression Of Il-1beta-Induced Transcription Factors Involved In An Inflammatory Pathway In Colonic Epithelial Cells, Wannaporn Chayalak, Sumpun Thammacharoen, Chatsri Deachapunya, Sutthasinee Poonyachoti

The Thai Journal of Veterinary Medicine

Flavonol quercetin (Q), found in vegetables and fruits, demonstrates the most potent anti-inflammatory effect. The preventive effect and cellular mechanisms of Q (Q1, Q10, and Q100 µM) on IL-1β induced leaky gut via the signaling molecules of inflammatory pathway, NF-κB p65-iκB/or p38/ERK1/2/MLCK/phospho(p)-MLC were investigated in Caco-2 cells. The cytotoxic effect of Q was initially determined by MTT assay. Transepithelial electrical resistance (TER) and apical-to-basolateral fluorescein isothiocyanate-labeled dextran (FD-4) flux were used to determine paracellular permeability. The protein expression of signaling molecules was examined by Western blot analysis, and their target MLCK mRNA expression was determined using real-time PCR. All Q …


Missing The Overlap, Rutwik Pradeep Sharma, Mohamed Mohamed Ahmed, Ryan Tam, Alexander T. Kusnik, Ali Jaan, Ari Chodos, Krishna Tangirala Aug 2024

Missing The Overlap, Rutwik Pradeep Sharma, Mohamed Mohamed Ahmed, Ryan Tam, Alexander T. Kusnik, Ali Jaan, Ari Chodos, Krishna Tangirala

Advances in Clinical Medical Research and Healthcare Delivery

A 43-year-old female presented with painful obstructive jaundice, a mixed pattern of elevation of liver injury markers and neutrophilic leukocytosis. Evaluation with endoscopic retrograde cholangiopancreatography (ERCP) was unremarkable. The antimitochondrial antibody (AMA) titers were elevated. She was discharged on ursodeoxycholic acid (UDCA) for Primary Biliary Cirrhosis (PBC) but was readmitted for worsening symptoms. The patient's liver biopsy results suggested Overlap syndrome (Primary Biliary Cirrhosis-Autoimmune hepatitis). She was then given corticosteroid therapy concurrently with UDCA after which she improved and remained asymptomatic. In conclusion, we would like to report this atypical presentation of overlap syndrome and hope the medical community learns …


A Presentation Of Acute On Chronic Pancreatitis Complicated By Pancreaticopleural Fistula Leading To Bilateral Exudative Pleural Effusions And Empyema, Ashruta Patel, Do, Ms Jul 2024

A Presentation Of Acute On Chronic Pancreatitis Complicated By Pancreaticopleural Fistula Leading To Bilateral Exudative Pleural Effusions And Empyema, Ashruta Patel, Do, Ms

The Journal of Integrated Primary Care

This case report highlights a rare but serious complication of acute pancreatitis, where pancreatic juice drains into the pleural space, causing bilateral exudative pleural effusions and potentially leading to empyema. The patient's history of alcohol abuse and splenic vein thrombosis likely contributed to the development of this complication. The clinical presentation, including progressive shortness of breath and pleuritic chest pain, along with findings on examination and imaging, prompted further investigation. The MRI findings of a pancreaticopleural fistula, along with a pseudocyst, were significant in diagnosing the condition. Treatment involved a multidisciplinary approach, including antibiotic therapy, chest tube placement to drain …


Sump Syndrome: The Forgotten Cause Of Painless Jaundice In The Elderly, Mark Ayoub, Amna Anees Jul 2024

Sump Syndrome: The Forgotten Cause Of Painless Jaundice In The Elderly, Mark Ayoub, Amna Anees

Journal of Community Hospital Internal Medicine Perspectives

Painless jaundice is a common presentation of abdominal malignancy seen in elderly patients. While malignancy may be a common cause of obstructive jaundice in that population group, anchor bias should always be avoided. We present a case of an elderly woman who presented with painless jaundice and weight loss. She had a very remote history of cholecystitis. She was found to have Sump syndrome due to a stricture at the Choledochoduodenostomy (CDD) site. She underwent endoscopic retrograde cholangiopancreatography (ERCP) with stent placement which shortly led to resolution of her jaundice. Biopsy from the stricture site came back negative for malignancy.


Trends, Predictors, And Outcomes Of Hepatic Encephalopathy Treatment At A Quaternary Transplant Center From 2012-2022, Patrick Twohig, Thoetchai Peeraphatdit, Kaeli Samson, Makayla Schissel, Lynette M. Smith, Kyaw Min Tun, Ellen Tan, Kyle Scholten, Jason Barbaretta, Kevin Brittan, Timothy Mccashland Jun 2024

Trends, Predictors, And Outcomes Of Hepatic Encephalopathy Treatment At A Quaternary Transplant Center From 2012-2022, Patrick Twohig, Thoetchai Peeraphatdit, Kaeli Samson, Makayla Schissel, Lynette M. Smith, Kyaw Min Tun, Ellen Tan, Kyle Scholten, Jason Barbaretta, Kevin Brittan, Timothy Mccashland

Graduate Medical Education Research Journal

Background: Hepatic encephalopathy (HE) is a devastating complication of cirrhosis that increases mortality. Many patients do not receive guideline recommended HE treatment.

Our aim is to evaluate trends in HE treatment over time, variables associated with receiving treatment, and outcomes based on the type of treatment received.

Methods: Retrospective single-center cohort study of hospitalized patients with HE from July 2012 – June 2022. HE treatment was defined as receiving lactulose, rifaximin, or combination therapy.

Results: A total of 1,683 unique patients were included, 72% of patients received HE treatment. Fewer HE patients received any treatment in 2022 (65.9%) compared to …


Anomalous Presentation And Endoscopic Findings Of Acute Esophageal Necrosis: A Case Report, Ahmed Shehadah, Abdullah A. Orakzai, Sheza Malik, Alshaima Yousef, Ali Jaan, Patrick Okolo Jun 2024

Anomalous Presentation And Endoscopic Findings Of Acute Esophageal Necrosis: A Case Report, Ahmed Shehadah, Abdullah A. Orakzai, Sheza Malik, Alshaima Yousef, Ali Jaan, Patrick Okolo

Advances in Clinical Medical Research and Healthcare Delivery

Introduction:

Acute esophageal necrosis (AEN), is a rare disorder with an estimated incidence of 0.01-0.28%. It typically affects the distal third of the esophagus. Approximately 90% of patients with acute esophageal necrosis present with upper gastrointestinal (GI) bleeding, primarily due to ischemic insult or severe hemodynamic compromise. In this report, we describe a case in which the patient presented with odynophagia and dysphagia, but without upper GI bleeding. The patient exhibited pan mucosal involvement of the esophagus, which extended to the gastric antrum.

Case: A 55-year-old man with a history of type 2 diabetes mellitus and substance abuse presented with …


Management Of Variceal Hemorrhage From Extensive Portal Vein Tumor Thrombus In Hepatocellular Carcinoma And Untreated Pheochromocytoma: A Case Report, Patrick Twohig, Kishan Patel, Tomoki Sempokuya, Chijoke Enweluzo, Lyudmila Muinov, Ishfaq Bhat May 2024

Management Of Variceal Hemorrhage From Extensive Portal Vein Tumor Thrombus In Hepatocellular Carcinoma And Untreated Pheochromocytoma: A Case Report, Patrick Twohig, Kishan Patel, Tomoki Sempokuya, Chijoke Enweluzo, Lyudmila Muinov, Ishfaq Bhat

Graduate Medical Education Research Journal

Background: Over 600,000 people in the United States (U.S.) have liver cirrhosis. It is estimated that 30% of patients with compensated cirrhosis and 60% of patients with decompensated cirrhosis will develop varices in their lifetime, with an incidence rate of new varices at 9% per year. Fifty percent of patients with esophageal varices will experience bleeding at some time. Pheochromocytoma is a rare catecholamine secreting adrenal gland tumor that occurs in 2-8 people per every 1 million people in the general population. Standard treatment for variceal bleeding includes endoscopic band ligation and/or radiologic embolization along with non-selective beta blockers. However, …


Surgery Of The Colon; The Impact Of Colostomy And Postoperative Complications On Patients' Quality Of Life, Vlad Denis Constantin, Adrian Silaghi, Dragos Epistatu, Daniela Gabriela Bălan, Florin Silviu Groseanu, Denisa Mihaela Nedelcu, Ioana Paunica Apr 2024

Surgery Of The Colon; The Impact Of Colostomy And Postoperative Complications On Patients' Quality Of Life, Vlad Denis Constantin, Adrian Silaghi, Dragos Epistatu, Daniela Gabriela Bălan, Florin Silviu Groseanu, Denisa Mihaela Nedelcu, Ioana Paunica

Journal of Mind and Medical Sciences

Introduction. This study aims to evaluate the impact of stoma formation on the quality of life of patients undergoing colonic surgery, considering both emergency and elective procedures. Several factors (demographic data, Charlson comorbidity score, type of surgical intervention, duration of hospitalization, postoperative outcomes and complications, etc.) were analyzed to understand their influence on patients' well-being. Materials and Methods. A retrospective analysis was performed on patients who underwent colorectal surgery that required stoma formation. A total of 270 patients were included in the study, with 69.25% undergoing emergency surgery and 30.74% undergoing elective procedures. Results. The Charlson comorbidity score was significantly …


Venous Thrombosis Associated With Pancreatic Cancer, Vlad Buică, Camelia Diaconu, Octavian Andronic Apr 2024

Venous Thrombosis Associated With Pancreatic Cancer, Vlad Buică, Camelia Diaconu, Octavian Andronic

Journal of Mind and Medical Sciences

Introduction. Cancer-associated thrombosis is a significant prognostic marker in pancreatic neoplasia, with a venous thromboembolism incidence of 17-34%. This study focuses on cancer-associated thrombosis risk factors, screening scores, and treatment options. Materials and Methods. Comprehensive database searches were conducted across Web of Science, PubMed, Reaxys, ScienceDirect, and Scopus. Results. Of the 37 articles reviewed, findings include splanchnic vein thrombosis correlating with pancreatic complications and survival rates. Gender differences in cancer-associated thrombosis risk were inconclusive, while African Americans showed a higher incidence of pulmonary embolism. Various cancer-associated thrombosis staging scores were evaluated, with ONKOTEV score outperforming Khorana. Direct oral anticoagulants were …


Ischemic Colitis In A Middle-Aged Man With Covid-19: Case Report And Review Of Literature, Lara Appiah, Subhasis Misra, Stephen Jones Apr 2024

Ischemic Colitis In A Middle-Aged Man With Covid-19: Case Report And Review Of Literature, Lara Appiah, Subhasis Misra, Stephen Jones

HCA Healthcare Journal of Medicine

Introduction

Coronavirus disease 2019 (COVID-19) was a pandemic that began in 2019 and continues to have morbid and deadly consequences throughout the world. During the beginning of the pandemic, many considered older adults and immunocompromised younger adults to be the only populations at risk for the severe consequences of COVID-19. Throughout the pandemic, this was proven wrong with several case reports and studies showing that relatively younger adults can also suffer serious consequences from this perplexing virus.

Case Presentation

We report a rare case of ischemic colitis in a 42-year-old obese man who presented to the emergency department with quintessential …