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Primary Malignant Melanoma of the Esophagus Presenting as Chronic Cough
Weskamp, Andrew L. DO1; Hudspath, Caleb B. DO1; Tritsch, Adam M. MD1
doi : 10.14309/crj.0000000000000645
August 2021 - Volume 8 - Issue 8 - p e00645
Biliary Drainage With Endoscopic Ultrasound-Guided Choledochoenterostomy in a Patient With Duodenal Switch Anatomy
Bomman, Shivanand MD1; Krishnamoorthi, Rajesh MD1
doi : 10.14309/crj.0000000000000648
August 2021 - Volume 8 - Issue 8 - p e00648
Colonoscopic Appearances of an Appendiceal Remnant: The Benign Masquerading as the Sinister
Haboubi, Hasan N. MBBS1; Hassall, James Henry MBBCH1; Collins, Hannah L. MBBCH2; Ellis-Owen, Rwth MBBCH3; Green, John MBBCH1
doi : 10.14309/crj.0000000000000655
August 2021 - Volume 8 - Issue 8 - p e00655
Ectopic Duodenal Varices in a Noncirrhotic Patient With Inferior Vena Cava Occlusion
Kothadia, Jiten P. MD1; Aleem, Abdul MD2; Raza, Abbas MD3
doi : 10.14309/crj.0000000000000653
August 2021 - Volume 8 - Issue 8 - p e00653
Giant Diverticular Surprise
Shah, Neal DO1; Razzano, Anthony MD2; Modayil, Rani MD2
doi : 10.14309/crj.0000000000000642
August 2021 - Volume 8 - Issue 8 - p e00642
De Novo Crohn's Disease Triggered After COVID-19: Is COVID-19 More Than an Infectious Disease?
Senthamizhselvan, Kuppusamy MD, DM1; Ramalingam, Rajendran MD1; Mohan, Pazhanivel MD, DM1; Kavadichanda, Chengappa MD, DM2; Badhe, Bhawana MD3; Hamide, Abdoul MD1
doi : 10.14309/crj.0000000000000652
August 2021 - Volume 8 - Issue 8 - p e00652
Coronavirus disease 2019 (COVID-19)-associated immune dysregulation is believed to trigger the onset of various autoimmune diseases. These occur either during active COVID-19 or soon after recovery. We report ileocolonic Crohn's disease in a 35-year-old woman after her recovery from a milder form of COVID-19. She achieved remission of her symptoms with oral corticosteroids and sulfasalazine.
Progression From Antral G-Cell Hyperplasia to Gastric Neuroendocrine Tumor in a Patient With Autoimmune Gastritis
Brown, Patrick DO1; Tetali, Bhavana BS2; Suresh, Suraj MD1; Varma, Adarsh MD1
doi : 10.14309/crj.0000000000000649
August 2021 - Volume 8 - Issue 8 - p e00649
Autoimmune metaplastic atrophic gastritis is caused by immune-mediated destruction of gastric parietal cells. This leads to the absence of gastric acid production, which causes compensatory hyperplasia of gastric antral G-cells leading to hypergastrinemia. The excess gastrin binds to enterochromaffin-like cells causing hyperplasia, which may progress to dysplasia and rarely to gastric neuroendocrine tumors. We present a rare case of autoimmune metaplastic atrophic gastritis associated with G-cell hyperplasia showing the full developmental spectrum of enterochromaffin-like cell proliferation from hyperplasia to dysplasia to neuroendocrine tumor.
Endoscopy-Induced Pancreatic Pseudocyst Rupture: A Case of Secondary Peritonitis After Upper Endoscopy
Robbins, Gordon MD1,2; Kantsevoy, Sergey MD1,2; Raina, Amit MD1,2
doi : 10.14309/crj.0000000000000651
August 2021 - Volume 8 - Issue 8 - p e00651
Pancreatic pseudocysts are often drained endoscopically after 4–6 weeks of maturation. Allowing for developed encapsulation ensures that the cyst walls are strong enough to sustain drainage. However, in 3%–5% of these cases, pseudocysts will rupture spontaneously and put patients at risk of peritonitis. We present the first documented case of pancreatic pseudocyst rupture after upper endoscopy. Exploratory laparotomy confirmed the absence of viscus perforation and highlighted the danger of any procedure that increases intra-abdominal pressure in a patient with a pancreatic pseudocyst. Awareness of this complication should impact our decision when considering endoscopy in patients with pancreatic pseudocysts.
Pancreatitis After Pancreaticojejunostomy Procedure? A Tale Involving the Tail of the Pancreas
Aggarwal, Manik MD1; Cartabuke, Richard H. MD1; Simons-Linares, Carlos Roberto MD2
doi : 10.14309/crj.0000000000000644
August 2021 - Volume 8 - Issue 8 - p e00644
Recurrent acute pancreatitis (RAP) involving the tail of the pancreas after pancreaticojejunosotomy (PJP) is rare, has very challenging management, and there is minimal literature. We describe a case of idiopathic RAP, complicated with chronic pancreatitis that failed medical and endoscopic management and required PJP. Unfortunately, RAP recurred after PJP, and we describe his clinical course and management.
An Unusual Case of Biliary Obstruction Because of Human Papillomavirus–Associated Metastatic Squamous Cell Carcinoma From Head and Neck Primary
Chopra, Maneera MD1; Bhakta, Dimpal MD2; Zhang, Songlin MD, PhD3; DaVee, Tomas MD, MSCI2
doi : 10.14309/crj.0000000000000633
August 2021 - Volume 8 - Issue 8 - p e00633
Secondary pancreatic tumors are uncommon, with the majority originating from primary gastrointestinal or lung cancers. We present the case of a 42-year-old woman with squamous cell carcinoma of the pancreas, found to be human papillomavirus–positive on in situ hybridization. After extensive work-up, the patient was determined to have a previously undiagnosed, asymptomatic head and neck primary malignancy. There is sparse literature discussing metastatic human papillomavirus–positive squamous cell carcinoma to the pancreas. This report highlights the importance of including this diagnosis when considering a differential for secondary pancreatic tumors, especially squamous etiology.
Eosinophilic Colitis in Recurrent Sigmoid Volvulus
Zucker, Kelly DO1; Pradhan, Faruq MD1; Gomez, Adam MD2; Nanda, Rakesh MD1
doi : 10.14309/crj.0000000000000650
August 2021 - Volume 8 - Issue 8 - p e00650
Eosinophilic colitis (EC) falls along the spectrum of a series of inflammatory gastrointestinal disorders in which eosinophils infiltrate the gut without known tissue eosinophilia. Eosinophilic gastrointestinal disorders include eosinophilic esophagitis, eosinophilic gastritis, and the least common EC. The presentation of EC is extremely variable in mucosal, submucosal, and transmural inflammation. We present a case of recurrent volvulus with histologic findings of eosinophilia.
No Microscope Needed: A Macroscopic Presentation of Collagenous Colitis
Boyd, Amanda L. MD1; Leiman, David A. MD, MSHP1,2; Dufault, Darin L. MD1
doi : 10.14309/crj.0000000000000657
August 2021 - Volume 8 - Issue 8 - p e00657
Microscopic colitis (MC) is a common cause of chronic secretory diarrhea with variable etiologies, including nonsteroidal anti-inflammatory drugs. As its name implies, the diagnosis requires consistent histopathologic findings that typically accompany normal-appearing mucosa. However, accumulating evidence suggests that the presence of distinct endoscopic features is associated with MC. We present a case of MC that highlights the importance of recognizing these macroscopic findings because they can aid in diagnosis and have significant management implications.
Multiorgan Dysfunction Related to Kratom Ingestion
Khan, Muhammad Zarrar MD1; Saleh, Mohannad Abou MD2; Alkhayyat, Motasem MD1; Roberts, Daniel E. MD3; Lindenmeyer, Christina C. MD2
doi : 10.14309/crj.0000000000000647
August 2021 - Volume 8 - Issue 8 - p e00647
Consumption of herbal supplements has been linked to multiorgan toxicities. Kratom is an herbal extract that has gained popularity for its analgesic and psychotropic properties. Several cases of kratom-induced liver injury have been reported, but data on multiorgan involvement remain scarce. We present the case of a 37-year-old woman who developed a mixed hepatocellular and cholestatic pattern of acute liver injury, acute kidney injury, and pancolitis after prolonged use of kratom-containing herbal supplements.
Sirolimus for the Treatment of Juvenile Polyposis in Childhood
Martín-Masot, Rafael MD1; Cardelo Autero, Nerea MD1; Ortiz Pérez, Pilar MD1; Torcuato Rubio, Encarnación MD1; Vázquez Pedreño, Luis MD2; Gallego Fernández, Carmen MD3; Blasco-Alonso, Javier MD1; Navas-López, Víctor Manuel MD1
doi : 10.14309/crj.0000000000000646
August 2021 - Volume 8 - Issue 8 - p e00646
Juvenile polyposis syndrome (JPS) is a rare disease with an autosomal dominant inheritance pattern characterized by the development of multiple hamartomatous polyps in the gastrointestinal tract. The most frequent signs and symptoms are recurrent abdominal pain, rectal bleeding, anemia, and iron deficiency. The treatment of JPS is symptomatic, requiring serial endoscopic polypectomies or intestinal resections in the most severe cases. We describe the clinical case of a patient with JPS with a childhood juvenile polyposis phenotype because of a mutation on the SMAD4 gene, who received treatment with sirolimus successfully.
