Digestive System Diseases Commons^™

Pemetrexed Induced Pancolitis: A Case Report, Jack Demirjian, Christina Tompkins, Amelia Mellor, Aasia Khan

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Robotic Whipple Procedure, Chris Robert, Soomal Memon, Umar Butt, Furrukh Jabbar

North Texas Research Forum 2025

Introduction: Pancreatic cancer is an aggressive tumor with surgery being the corner stone of multidisciplinary treatment. Pancreaticoduodenectomy is a technically demanding procedure associated with significant morbidity. Case presentation: 70-year-old man with a past history of hypertension presented with jaundice, dark urine and a total bilirubin of 24. His CT scan showed biliary and pancreatic ducal dilation. An EUS revealed a 2cm pancreatic mass with an intact interface between the mass and splenoportal confluence, the biopsy was suggestive of poorly differentiated adenocarcinoma. We performed a Robotic Whipple procedure. Robotic Whipple surgery is superior in meticulous dissection of the retro pancreatic tunnel. …

Successful Treatment Of Mirizzi Syndrome With Spyglass-Guided Electrohydraulic Lithotripsy, Bushra Bangash, Aakriti Soni, Galvin Dhaliwal, Ahmed Ouni

Gulf Coast Division GME Research Day 2025

No abstract provided.

A Hidden Source Of Ostomy Bleeding: Meckel Diverticulum, Shiva Morisetty, Ezekiel Kapusiak, Kumar Shah

East Florida Division GME Research Day 2025

Adult Meckel diverticulum can present atypically compared to classic childhood Meckel diverticulum. Given the increased likelihood of concurrent medical conditions in adults, it is often overlooked in the differential for lower gastrointestinal bleeding. We report a 61-year-old male with rectal adenocarcinoma status post low anterior resection and diverting loop ileostomy who presented repeatedly with hematochezia via the ostomy. Prior episodes were managed conservatively. During the index admission, esophagogastroduodenoscopy and ileoscopy did not identify a bleeding source; a clip was placed near the suspected site. Interventional radiology was consulted for mesenteric angiography. Superior mesenteric angiography demonstrated a tortuous aberrant ileal branch …

Breaking The Blockade: A Retrospective Analysis Of Pediatricconstipation In Hospitalized Patients, Yenamala Reddy, Jaicy Pottokaran, Eric K. Shaw, Aimee Behnke, Jean B. Wiggins, Lauren Hebert, Norman Taylor Parks

South Atlantic Division GME Research Day 2025

No abstract provided.

A Case Of Gastric Outlet Obstruction Secondary To A Gallstone, Mahesh Tummala, Adam Devine, Akash Tummala, Livasky Concepcion-Perez

East Florida Division GME Research Day 2025

Introduction: Bouveret syndrome is characterized by a gallstone passing through a bilioenteric fistula causing gastric outlet obstruction and represents 1-3% of gallstone obstructions. Fistualization occurs when chronic inflammation from the gallstone on the gallbladder wall leads to ischemia and perforates into the bowel. Over 60% of patients with cholelithiasis are asymptomatic. Biliary colic is the most common presentation in symptomatic patients. A biliary fistula occurs in 3-5% of cases and just 7-10% of these cases lead to gallstone ileus. The highest prevalence is among women of advanced age. Typical presentation is with general symptoms of nausea/vomiting and vague abdominal pain. …

National Outcomes Of Pre-Emptive Tips In Patients With Acute-On-Chronic Liver Failure And Variceal Bleeding, Aya Akhras, Waseem Wahood, Azizullah Beran, Bisher Sawaf, Asad Ur Rahman, David Goldberg, Muhammed U. Shahid

East Florida Division GME Research Day 2025

Background

Pre-emptive transjugular intrahepatic portosystemic shunt (pTIPS), defined as placement within 72 hours of initial endoscopic therapy for an active variceal bleed, has been proposed as a strategy to reduce rebleeding and improve survival in high-risk patients with cirrhosis. We evaluated outcomes of patients with acute-on-chronic liver failure (ACLF) who presented with variceal bleeding and underwent therapeutic endoscopy (EGD) with or without the addition of pre-emptive TIPS.

Methods

The Nationwide Readmissions Database (2010–2022) was queried for patients with ACLF using previously validated algorithms admitted with variceal upper GI bleeding who received endoscopic intervention. Patients were stratified into two groups: therapeutic …

An Unexpected Source Of Gi Bleeding: Enteric Muco-Submucosal Elongated Polyp In The Proximal Jejunum With Literature Review, Galvin Dhaliwal, Dev Patel, Ashvin Singh Dhaliwal, Aakriti Soni, Bilal Ashraf, Shane Sweeney, Sushovan Guha, Ahmed Ouni

Gulf Coast Division GME Research Day 2025

No abstract provided.

Turmeric, Red Yeast Paste, And Statins: A Recipe For Dili, John V. Nahas, Sinay Ceballos, Franklin Kasmin

East Florida Division GME Research Day 2025

Introduction Drug induced liver injury (DILI) contributes to a significant portion of acute liver injuries and acute liver failure in the west. DILI accounts for approximately 11% of acute liver failure cases in the US according to ACG. Insulting agents are numerous and well documented in the NIH LiverTox database, however the rarity and complexity of individual agents is a matter of ongoing study. Case Description/Methods A 52 year old man with PMH of HTN and HLD presents for a 2 week history of abdominal swelling, bilateral lower extremity swelling, decreased appetite, and positional shortness of breath. He endorses occasionally …

Microbial Remodeling Of Gut Tryptophan Metabolism And Indole-3-Lactate Production Regulate Epithelial Barrier Repair And Viral Suppression In Human And Simian Immunodeficiency Virus Infections, Clarissa Santos Rocha, Katie L. Alexander, Carolina Herrera, Mariana G. Weber, Irina Grishina, Lauren A. Hirao, Dylan J. Kramer, Juan Arredondo, Abigail Mende, Katti R. Crakes, Anne N. Fenton, Maria L. Marco, David A. Mills, John C. Kappes, Lesley E. Smythies, Paul Ziprin, Sumathi Sankaran-Walters, Phillip D. Smith, Satya Dandekar

Department of Obstetrics & Gynecology Faculty Publications

Gut inflammatory diseases cause microbial dysbiosis. Human immunodeficiency virus-1 (HIV) infection disrupts intestinal integrity, subverts repair/renewal pathways, impairs mucosal immunity and propels microbial dysbiosis. However, microbial metabolic mechanisms driving repair mechanisms in virally inflamed gut are not well understood. We investigated the capability and mechanisms of gut microbes to restore epithelial barriers and mucosal immunity in virally inflamed gut by using a multipronged approach: an in vivo simian immunodeficiency virus (SIV)-infected nonhuman primate model of HIV/AIDS, ex vivo HIV-exposed human colorectal explants and primary human intestinal epithelial cells. SIV infection reprogrammed tryptophan (TRP) metabolism, increasing kynurenine catabolite levels that are …

Therapeutic Roles For Alkaline Phosphatases To Target Intestinal Dysfunction In Mouse Models Of Experimental Sepsis And Ischemic Stroke, Rhiannon V. Macom

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Therapeutic Roles for Alkaline Phosphatases to Target Intestinal Dysfunction in Mouse Models of Experimental Sepsis and Ischemic Stroke

Rhiannon V. Macom

Stroke is a disease that primarily affects the brain; however, ongoing research continues to show that stroke has far reaching systemic effects that can affect both short- and long-term recovery. The gastrointestinal tract has been shown to be affected post-stroke, and these effects are likely due to the bidirectional communication between the gut and the brain via the gut-brain-axis. Alkaline phosphatases (APs) are common membrane bound enzymes that are known to have a role in mitigating inflammation. The …

Pill Impaction Unmasking Eosinophilic Esophagitis And Acute Ulcerative Herpes Simplex Esophagitis In An Immunocompetent Patient, Fernando Lugo-Hernandez, Omar Jureyda, Bhavtosh Dedania

West Florida Division GME Research Day 2025

No abstract provided.

A Case-Control Comparison Of Alopecia Areata And Inflammatory Bowel Disease, Mohammad Fardos, Amritpal Kooner, Rawle A. Sekhon, Beniamin Zeka, Aditya Dutt, Richard Miller

West Florida Division GME Research Day 2025

No abstract provided.

Adult-Onset Iga Vasculitis And Nephropathy In Alcoholic Cirrhosis: A Case Report And Brief Review, Brett Thomas, Summer Wong, Walaa Abualhuda, Siddhi Patodia, Elaine Bruno, David Esguerra, Richard Miller

West Florida Division GME Research Day 2025

No abstract provided.

Blurry With A Chance Of Ultrasound: A Case Of Sudden Vision Loss, Anjeza Cipi, Emily Sealy

Department of Emergency Medicine Faculty Publications

[Case presentation] A 30-year-old man with Crohn’s disease presented to the emergency department (ED) with sudden, painless vision loss in his left eye. He described a central dark spot that rapidly progressed over 5 minutes to near-complete central vision loss, sparing peripheral vision. He denied trauma, exertion, Valsalva, or anticoagulant use. Point-of-care ultrasound (POCUS) was performed on supine patient using a high-frequency linear probe (10-15 MHz) with copious gel over the closed eyelid, avoiding direct pressure. While instructing the patient to look in different directions, the eye was scanned in its entirety in transverse and sagittal planes. Gain and depth …

Chronic Administration Of A Cannabis-Derived Mixture At An Antihyperalgesic Dose Does Not Significantly Enhance Hepatotoxicity Or The Development Of Metabolic Dysfunction-Associated Steatohepatitis In Male Mice, Kim B. Pedersen, Tomislav Jelesijevic, Tamara M. Morris, Sarah M. Melton, Ashley S. Henderson, John F. Glenn, Gregory J. Davenport, Martin J.J. Ronis, Peter J. Winsauer

School of Medicine Faculty Publications

Cannabis and cannabinoid mixtures have been linked to a variety of health benefits including pain mitigation, suppression of nausea produced by chemotherapeutic agents, anti-inflammatory effects, and effects on energy homeostasis, glucose, and lipid metabolism. The latter properties have led to the suggestion that these products could have therapeutic effects on the development of metabolic dysfunction-associated steatohepatitis (MASH) - a severe type of liver pathology in obese and diabetic patients. However, varying agonist and antagonistic properties of different cannabinoids on the endogenous cannabinoid system make prediction regarding hepatic effects and diet interactions difficult. The current study was designed to examine hepatic …

Opioid Tolerance And Withdrawal In The Mouse Colon, James Fune

Theses and Dissertations

Constipation is a major clinical obstacle associated with opioids, prompting patients to discontinue treatment due to pain, discomfort, and psychosocial stressors. Moreover, chronic users become tolerant to the analgesic effects of opioids, but not to their constipating effects. Upon cessation of long-term treatment, serious diarrhea–among other somatic signs of withdrawal–may ensue. These symptoms become a driving factor for relapse, causing patients to restart opioid treatment. In this study, we aim to understand mechanisms that contribute to opioid tolerance and withdrawal in the colon. Previous findings suggest that constipation occurs partly due to the colon’s lack of tolerance to opioids’ inhibitory …

Pancreatic Cancer In Appalachia: An Examination Of Detection, Associated Factors, And Provider Experiences With A Focus On West Virginia, Melissa Mae Elder

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Pancreatic Cancer in Appalachia: An Examination of Detection, Associated Factors, and Provider Experiences with a Focus on West Virginia

Melissa M. Elder

Introduction: The Appalachian population accounts for a substantial proportion of the United States and are uniquely susceptible to health care disparities. The Appalachian Regional Commission has reported on the inequities found within the Appalachian region as part of its formal establishment in 1965. When compared to the Non-Appalachian U.S., Appalachia experiences a higher incidence of chronic disease such as diabetes, cancer, lung, and liver disease; mortality from diseases of despair constituting prescription drug, alcohol, illegal drug use, …

Autoimmune Pancreatitis Not Otherwise Specified (Aip-Nos): The Importance Of Gastroenterology Consultation When Clinical Findings Are Concerning For Pancreatic Cancer, Cooper Alden Josephs, Daniel Mullady, Nicholas Fuerstenau, Steve Xie, Taylor Templeton-Jager

South Atlantic Division GME Research Day 2025

No abstract provided.

Cryptogenic Fusobacterium Liver Abscesses In Two Healthy, Young Adult Males, Cooper Alden Josephs, Anna Bryce Tucker, James Everhart, Nick Fuerstenau, Taylor Templeton-Jager

South Atlantic Division GME Research Day 2025

No abstract provided.

E. Coli Sepsis And Cholangitis In A Patient With Sickle-Cell Disease: A Case Report, Madeline Pham, Kristen Stovall, Marvin Sineath Jr.

South Atlantic Division GME Research Day 2025

No abstract provided.

Clinical Presentation And Management Of Littoral Cell Angioma: A Case Report, Rebecca Ashton Taylor, Steven Carpenter

South Atlantic Division GME Research Day 2025

No abstract provided.

Gastric Volvulus Presenting As Gastric Outlet Obstruction In An Elderly Patient: A Case Report, Gautham Mudireddy, Cooper A. Josephs, George Aragon

South Atlantic Division GME Research Day 2025

No abstract provided.

Rectal Lactulose Induces Hypernatremia And Increases Mortality In Patients With Cirrhosis And Hepatic Encephalopathy, Abhinav K. Rao, Don C. Rockey

South Atlantic Division GME Research Day 2025

No abstract provided.

A Case Of An Undocumented Immigrant With Rectal Adenocarcinoma, Rajiv Shah, Nizar Hallak, Selent Cameron

South Atlantic Division GME Research Day 2025

No abstract provided.

A Rare Case Of Eosinophilic Gastrointestinal Disease With Transmural Wall Involvement, Ibrahim Al-Saadi, Shivam Kalra, Abhinav Rao, Laura L. Brant, Salvatore A. Moscatello, Jose D. Espinal-Marriote

South Atlantic Division GME Research Day 2025

No abstract provided.

The Fluid Resuscitation Paradox: Refractory Shock In A Patient With Recurrent Ascites And Encapsulating Peritoneal Sclerosis, Chiraag Ashokkumar, Justin Gisel

South Atlantic Division GME Research Day 2025

No abstract provided.

Surgical Outcomes Of Median Arcuate Ligament Release, Savannah Yeh, Alina Chen, Yasmeen Dhindsa, Peter Lawrence, Karen Woo

South Atlantic Division GME Research Day 2025

No abstract provided.

Diverticulitis—New Evidence To Share With Patients, Nicholas B. D'Alessandro, Tarun Vippa, Edward C. Oldfield Iv, David A. Johnson

Department of Medicine Faculty Publications

Diverticulitis is one of the most common gastrointestinal causes of hospitalization in Western society. While previously characterized as a disease of older patients, new literature highlights an increasing incidence among the younger population. Over the past few decades, the understanding of etiology and management of diverticulitis has changed drastically. New data refute past beliefs while promoting other novel recommendations to mitigate incidence and subsequent complications. Data now confirms the safety and possible protective benefit of particulate food, while highlighting evidence-based approaches for the use of diagnostic imaging and antibiotics. We recognize modifiable and non-modifiable risk factors that are commonly seen …

Bcg-Induced Dna Methylation Changes Improve Coronavirus Disease 2019 Vaccine Immunity Without Decreasing The Risk For Severe Acute Respiratory Syndrome Coronavirus 2 Infection, Santiago Carrero Longlax, Kent J Koster, Ashish M Kamat, Marisa Lozano, Seth P Lerner, Rebecca Hannigan, Tomoki Nishiguchi, Abhimanyu, Daanish Sheikh, Malik Ladki, Alexandra Portillo, Amrit Koirala, Tajhal D Patel, Zoe Spieler, Aaron B Benjamin, Maxim Lebedev, Theresa U Ofili, Robert W Hutchison, George Udeani, Lynne A Opperman, Gabriel Neal, Anna M Mandalakas, Mihai G Netea, Moshe Arditi, Pablo Avalos, Sandra L Grimm, Cristian Coarfa, Jeffrey D Cirillo, Andrew R Dinardo

Faculty, Staff and Students Publications

BACKGROUND: The BCG vaccine induces trained immunity, an epigenetic-mediated increase in innate immune responsiveness. Therefore, this clinical trial evaluated if BCG-induced trained immunity could decrease coronavirus disease 2019 (COVID-19)-related frequency or severity.

METHODS: A double-blind, placebo-controlled clinical trial of healthcare workers randomized participants to vaccination with BCG TICE or placebo (saline). Enrollment included 529 healthcare workers randomized to receive BCG or placebo. Primary analysis evaluated COVID-19 disease frequency, while secondary analysis evaluated coronavirus immunity in a subset of participants. Study enrollment ceased early in December 2020 following introduction of COVID-19-specific vaccines.

RESULTS: Study enrollment was halted early, prior to reaching …