Gastroenterology Commons^™

Hemophagocytic Lymphohistiocytosis: A Series Of Five Clinical Cases In Adult Patients At A Single Institution With A Review Of The Literature, David Thomas, Nihar Shah Md, Hiren Patel, Tapan Pandya, Dron Gauchan, Michael Maroules

Gastroenterology

Context: Hemophagocytic Lymphohistiocytosis or the “Hemophagocytic Syndrome” is a spectrum of disorders of regulatory immunomodulatory pathways inciting phagocytosis of hematopoietic cells resulting in end-organ damage. The condition appears in both heritable and non-heritable forms from a multitude of possible environmental triggers, most notably infection. The condition often results in a fatal outcome without prompt diagnosis and treatment. Cases in children have been reported much more frequently and classically than in adult patients.

Case Report: In this case series we examined fi ve such cases in adult patients that were found at our institution in a window as small at 2 …

Enterogenous Cyst Of The Small Bowel Causing Intussusception In An Adult: Case Report And Review Of Literature, Nihar Shah Md, Therese Lizardo-Escaño, Hamid Shaaban, Gautamy Dhadham, Arya Karki, Robert Spira

Gastroenterology

Small bowel intussusception is a rare congenital disease entity, mostly manifesting before the age of two with abdominal pain and acute intestinal obstruction. In adults, colon intussusception is a rare event causing approximately 1% of all acute intestinal obstructions and they can occur idiopathically in adults or due to an intraluminal tumor mass. We report a case of an enterogenous cyst causing intussusception and iron deficiency anemia in an adult treated by surgical excision and resection of the small bowel.

Intravenous Immunoglobulin In The Treatment Of Severe Clostridium Difficile Colitis, Nihar Shah Md

Gastroenterology

Intravenous immunoglobulin (IVIG) has been utilized in patients with recurrent and refractory Clostridium difficile colitis. It is increasingly being used in patients with initial clinical presentation of severe colitis. Herein, we report a case of severe C. Difficile colitis successfully treated with IVIG with a review of the medical literature to identify the optimal timing and clinical characteristics for this treatment strategy.

Replacement Gastrostomy Tube Causing Acute Pancreatitis: Case Series With Review Of Literature, Anish M. Shah, Nihar Shah Md, Joseph R. Depasquale

Gastroenterology

Context Percutaneous endoscopic gastrostomy (PEG) feedings are generally considered safe with few serious complications. Acute pancreatitis is a rare complication associated with replacement percutaneous endoscopic gastrostomy tubes.

Case report We report two cases of acute pancreatitis induced by migrated replacement percutaneous endoscopic gastrostomy tubes.

Conclusions Migration of a balloon into the duodenum can result in external manipulation of the ampulla of Vater thereby disturbing the flow of pancreatic secretions leading to acute pancreatitis. Recognition of this complication is important and should be included as potential etiology of acute pancreatitis in patients receiving percutaneous endoscopic gastrostomy feedings. Periodic examination and documentation …