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First Reported Case of Deglutition Syncope With Underlying Suppurative Parotitis
Waqar, Syed Hamza Bin MD1; Khan, Anosh Aslam MD2; Mohiuddin, Osama MD2; Sheikh, Taha MD3
doi : 10.14309/crj.0000000000000643
September 2021 - Volume 8 - Issue 9 - p e00643
Deglutition syncope and carotid sinus hypersensitivity are neurally mediated events, leading to potentially dangerous arrhythmias and cardiovascular events. Mostly related to underlying gastroesophageal or cardiovascular causes, sometimes, this might not be the case. We report the first-ever documented case of deglutition syncope with acute suppurative parotitis, which resolved after resolving the parotid gland's swelling.
Metastatic Testicular Embryonal Carcinoma Presenting as Gastrointestinal Hemorrhage
Park, Nathan MD1; Han, James MD2; Shah, Sagar BS1; Chahine, Anastasia MD1; Samarasena, Jason MD2
doi : 10.14309/crj.0000000000000654
September 2021 - Volume 8 - Issue 9 - p e00654
Testicular cancer is the most common malignancy in men aged 20–35 years, usually presenting with painless scrotal swelling. Metastases, should they occur, frequently involve retroperitoneal lymph nodes, which drain the testes. Gastrointestinal (GI) metastases are rare, and metastatic disease may not initially be considered in a young man presenting with GI hemorrhage. This case demonstrates the importance of evaluating for a primary underlying malignancy, especially if other causes of GI hemorrhage have been ruled out. Testicular primary should additionally be considered in men because early intervention may often lead to improved clinical outcomes.
A Case of Lansoprazole-Induced Bullous Pemphigoid After Zantac Recall
Tran, Minh MD1; Armenta, Andrew M. MD2; Wilkerson, Michael G. MD2; Afrouzian, Marjan MD1,3; Khan, Kashif MD4
doi : 10.14309/crj.0000000000000664
September 2021 - Volume 8 - Issue 9 - p e00664
Proton pump inhibitors (PPIs) are the mainstay of treatment for many gastric acid-related diseases with a relatively safe drug profile. One of the rare side effects is PPI-induced bullous pemphigoid. We describe a case of new-onset bullous pemphigoid on initiation of lansoprazole for esophagitis after a nationwide Zantac recall. This condition can improve with the cessation of PPI and the use of corticosteroids. However, it poses a significant challenge to the management of gastroesophageal reflux disease by limiting available pharmacologic options. In addition, this case highlights the negative effects of a drug recall.
A Case of Multiple Perineuriomas in the Colon With Underlying Neurofibromatosis Type I
Tsuchiya, Tomoaki MD1,*; Iwaya, Yugo MD, PhD1,*; Iwaya, Mai MD, PhD2,*; Okamura, Takuma MD, PhD1,*; Nagaya, Tadanobu MD, PhD1,*; Umemura, Takeji MD, PhD1,*
doi : 10.14309/crj.0000000000000665
September 2021 - Volume 8 - Issue 9 - p e00665
A 45-year-old woman was referred to us after a positive fecal occult blood test. Colonoscopy revealed a 20-mm polyp in the transverse colon and a 10-mm polyp in the sigmoid colon. Endoscopic mucosal resection was performed as a diagnostic treatment. Both resected polyps were histologically diagnosed as perineuriomas. She was later found to exhibit multiple café-au-lait spots on the skin and subsequently diagnosed as having neurofibromatosis type I (NF-1). Perineuriomas are rare benign peripheral nerve sheath tumors, with no reports of multiple colonic lesions in a patient with NF-1 to date. NF-1 might be associated with the onset of multiple perineuriomas.
Laparoscopic Right Hemicolectomy to Curatively Treat Primary Leiomyosarcoma at the Ileocecal Valve
Wong, Gordon S. BS1; Yudina, Svetlana V. MD2; Reyes, Maria Cecilia D. MD3
doi : 10.14309/crj.0000000000000670
September 2021 - Volume 8 - Issue 9 - p e00670
Primary leiomyosarcomas of the colon (PLC) are rare tumors, representing 0.12% of all colon malignancies. We report a 59-year-old man with weight loss, mild anemia, and rectal bleeding. Colonoscopy revealed a 3.2 × 2.6-cm mass at the ileocecal valve. Histopathological examination of the biopsy showed a spindle cell neoplasm that stained positive for smooth muscle actin, caldesmon, and desmin. A diagnosis of PLC was made. Subsequently, a laparoscopic right hemicolectomy was performed, and no local recurrence was noted 6 months after the resection. Given the rarity of PLC, more studies on the clinical features and treatments of this tumor are warranted.
Incidental Hepatic Granulomata as the Initial Presentation of Crohn's Disease in a Pediatric Patient
Mostafavi, Mojdeh MD1; Sayej, Wael MD2; Hansen, Blake MD3; Cretara, Anthony MD4; Mueller, James MD4; Hirsch, Barry MD2
doi : 10.14309/crj.0000000000000662
September 2021 - Volume 8 - Issue 9 - p e00662
We describe a 9-year-old girl who presented with abdominal pain, found incidentally to have multiple liver granulomata. Extensive autoimmune and infectious workup was negative. The patient had esophagogastroduodenoscopy and colonoscopy, confirming the diagnosis of Crohn's disease. Hepatic granulomata are a rare complication of Crohn's disease and are often secondary to pharmacotherapy or infection in immunosuppressed patients. This case, to our knowledge, is the first reported case of a pediatric patient diagnosed with Crohn's disease after initially presenting with hepatic granulomata as an extraintestinal manifestation of the disease.
Successful Minimally Invasive Management of a Gastroduodenal Artery Pseudoaneurysm Causing Extrinsic Bile Duct Compression
Shell, Mark DO1; Reinhart, Evan DO1; Smith, Stephen MD1; DeMarris, Darryl MD2; Naumann, Christopher MD1
doi : 10.14309/crj.0000000000000663
September 2021 - Volume 8 - Issue 9 - p e00663
Gastroduodenal artery (GDA) pseudoaneurysms are rare clinical entities that typically develop in the setting of chronic inflammation of the pancreas, although idiopathic pseudoaneurysms can occur. Although GDA pseudoaneurysms carry the risk of rupture with resultant hemorrhage, they seldom are reported to cause biliary obstruction. We report a unique case of biliary obstruction secondary to extrinsic compression of the bile duct by a GDA pseudoaneurysm successfully managed by nonoperative means.
Disseminated AIDS-Related Kaposi Sarcoma Immune Reconstitution Inflammatory Syndrome With Infiltrative Liver Disease
Van, Jeremy DO1; Reau, Nancy MD2
doi : 10.14309/crj.0000000000000660
September 2021 - Volume 8 - Issue 9 - p e00660
Clinically significant hepatic acquired immunodeficiency syndrome–related Kaposi sarcoma is rarely described in the literature. Kaposi sarcoma immune reconstitution inflammatory syndrome may play a role in the rapid progression of clinically insignificant to significant liver disease. We present an acquired immunodeficiency syndrome patient with disseminated Kaposi sarcoma that developed 3–6 weeks after initiation of highly active antiretroviral therapy.
Pseudomelanosis Duodeni After Dialysis Initiation in Long-Standing Kidney Disease
Deliwala, Smit S. MD1; Hussain, Murtaza S. MD1; Ponnapalli, Anoosha MD1; Wiggins, Brandon DO, MPH1; Beere, Thulasi MD1; Kunaprayoon, Lalida MD1; Lakshman, Harini MD1; Gurvits, Grigoriy E. MD, FACP, FACG, AGAF2
doi : 10.14309/crj.0000000000000658
September 2021 - Volume 8 - Issue 9 - p e00658
A Case of Osseous Metaplasia in a Gastric Hyperplastic Polyp
Zhang, Yingtao MD, PhD1; Friedman, Mark MD2; Nakanishi, Yukihiro MD, PhD1
doi : 10.14309/crj.0000000000000667
September 2021 - Volume 8 - Issue 9 - p e00667
An Uncommon Case of Small Bowel and Pancolonic Varices
Baldwin, Nicholas K. MD1; Ravi, Sujan MD2; Shoreibah, Mohamed MD2; Kamath, Patrick S. MD3
doi : 10.14309/crj.0000000000000666
September 2021 - Volume 8 - Issue 9 - p e00666
An Unusual Case of Dysphagia
Helson, Erin MD1; Seow, Cynthia H. MBBS (Hons), MSc, FRACP1,2,3; Nasser, Yasmin MD, PhD, FRCPC1,2
doi : 10.14309/crj.0000000000000661
September 2021 - Volume 8 - Issue 9 - p e00661
