Penetrating Toothpick in the Portal Vein Resulting in Refractory Multifocal Liver Abscesses

Kurin, Michael MD1; Jin-Dominguez, Fangyuan MD2; Sclair, Seth MD1,3

doi : 10.14309/crj.0000000000000615

June 2021 - Volume 8 - Issue 6 - p e00615

خرید پکیج و مشاهده آنلاین مقاله

Biliary-Colonic Fistula Associated With High-Grade Biliary Stenosis From Errant Surgical Clip During Previous Biliary Surgery: Diagnosis and Treatment By ERCP

Hanna, Angy MD1; Aneese, Andrew M. MD1; Cappell, Mitchell S. MD, PhD1,2

doi : 10.14309/crj.0000000000000617

June 2021 - Volume 8 - Issue 6 - p e00617

خرید پکیج و مشاهده آنلاین مقاله

Small Bowel Giant Polypoid Gastric Heterotopia Causing Refractory Iron Deficiency Anemia

Ihionkhan, Ehizokha O. BA1; Odenwald, Matthew A. MD2; Ayoub, Fares MD2; Kumar, S. Dharan MD3; McDonald, Edwin K. IV MD2

doi : 10.14309/crj.0000000000000623

June 2021 - Volume 8 - Issue 6 - p e00623

خرید پکیج و مشاهده آنلاین مقاله

Percutaneous Transhepatic Single-Operator Cholangioscopy-Guided Intraductal Stone Therapy in a Liver Transplant Patient With Ischemic Cholangiopathy

Stadmeyer, Peter MD1; Dalvie, Prasad MD2; Hubers, Jeffrey MD1; Gopal, Deepak MD, FRCP(C), FACG1

doi : 10.14309/crj.0000000000000595

June 2021 - Volume 8 - Issue 6 - p e00595

Ischemic cholangiopathy is a feared complication after liver transplantation. We present a 68-year-old man who is status postorthotopic liver transplant from a donation after cardiac death. His posttransplant course was complicated by the development of a biliary anastomotic stricture, ischemic cholangiopathy, biloma, recurrent cholangitis, and intrahepatic stones. Through the use of antegrade cholangioscopy with a single-operator cholangioscope (SpyGlass 2; Boston Scientific, Boston, MA) passed through a percutaneous sheath, we were able to visualize impacted stones within the left intrahepatic system and treat them using electrohydraulic lithotripsy for stone fragmentation and removal.

خرید پکیج و مشاهده آنلاین مقاله

Spontaneous Biloma Secondary to Choledocholithiasis

Arramón, Marianela MD1; Sciarretta, Martín MD1; Correa, Gustavo Javier MD1; Yantorno, Martín MD1; Redondo, Agustina MD1; Baldoni, Fernando MD1; Tufare, Francisco MD1

doi : 10.14309/crj.0000000000000620

June 2021 - Volume 8 - Issue 6 - p e00620

A biloma is a collection of bile located outside the bile duct which occurs as a result of iatrogenic and traumatic injuries. Spontaneous biloma is rare and is associated with choledocholithiasis. Diagnosis is performed using an ultrasound, a computed tomography scan, and a nuclear magnetic resonance scan, and is confirmed by drainage and subsequent biochemical analysis of the fluid sample. The first treatment option is percutaneous drainage, and if not successful, endoscopic biliary drainage should be performed. We report a case of a 46-year-old patient with a spontaneous biloma associated with choledocholithiasis.

خرید پکیج و مشاهده آنلاین مقاله

A Masked Diagnosis: Sigmoid Endometriosis

Subbaraj, Lakshmipriya MD1,2; Bowman, Christopher J. MD, PhD3; Singh, Aparajita MD, MPH2

doi : 10.14309/crj.0000000000000557

June 2021 - Volume 8 - Issue 6 - p e00557

Serosal involvement in intestinal endometriosis is relatively common, and patients often present with nonspecific gastrointestinal symptoms; however, presentation with deeper mucosal infiltration and rectal bleeding is rare. We report a case of a 40-year-old woman with a history of breast cancer in remission who presented with periodic rectal bleeding and abdominal pain. Computed tomography scan showed sigmoid lesions concerning for metastatic disease. Colonoscopy showed hypervascular sigmoid lesions which were confirmed to be endometriosis on histopathology. This case highlights endometriosis as a rare differential to be considered in young women with abnormal bowel imaging or catamenial rectal bleeding.

خرید پکیج و مشاهده آنلاین مقاله

Biliary Obstruction After Transjugular Intrahepatic Portosystemic Shunt Placement

Patel, Feenalie MD1; Bick, Benjamin MD2

doi : 10.14309/crj.0000000000000618

June 2021 - Volume 8 - Issue 6 - p e00618

A 19-year-old man with noncirrhotic portal hypertension status post transjugular intrahepatic portosystemic shunt, gastric esophageal varices status post coil embolization, and thrombophilia because of Factor V Leiden heterozygosity presented with jaundice and elevated liver enzymes. His cholangiogram during endoscopic retrograde cholangiopancreatography demonstrated biliary tract obstruction at the bifurcation of the right and left hepatic ducts. With the aid of digital single-operator cholangioscopy, the patient was found to have a perforation of the common hepatic duct from the shunt. This case presents a novel use for digital single-operator cholangioscopy in identifying this rare complication and appropriately differentiating biliary compression vs perforation from transjugular intrahepatic portosystemic shunt.

خرید پکیج و مشاهده آنلاین مقاله

Infectious Abscess as Complication of Steroid Injection With Dilation of Refractory Upper Gastrointestinal Strictures

Voaklander, Rebecca MD1; Fang, John MD1

doi : 10.14309/crj.0000000000000619

June 2021 - Volume 8 - Issue 6 - p e00619

Benign, refractory upper gastrointestinal strictures can be challenging to treat. Dilation combined with intralesional steroid injection is part of treatment algorithms. This intervention is typically well-tolerated, and few complications of this technique have been reported in the literature. We report 2 patients with infectious abscesses, 1 involving the neck and 1 involving the pylorus, as a complication of steroid injection and dilation of refractory strictures.

خرید پکیج و مشاهده آنلاین مقاله