Rectal Ulcer After Rectal Washing With a Bidet Toilet

Choi, Jeongmin MD1

doi : 10.14309/crj.0000000000000754

February 2022 - Volume 9 - Issue 2 - p e00754

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Hepatocellular Carcinoma With Gastric Metastasis

Eskarous, Hany MD1; Patel, Dhruv MD2; Geme, Berhanu MD2; Krishnamurthy, Mahesh MD1

doi : 10.14309/crj.0000000000000750

February 2022 - Volume 9 - Issue 2 - p e00750

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Neonatal Intestinal Obstruction Due to Kaposiform Hemangioendothelioma of the Jejunum

Maddileti, Varunkumar MCh1; Mammen, Abraham MCh1; Kuruvilla, Shalini MD2

doi : 10.14309/crj.0000000000000749

February 2022 - Volume 9 - Issue 2 - p e00749

Kaposiform hemangioendothelioma is a borderline vascular tumor usually seen in infants and children as cutaneous lesions classically associated with the Kasabach-Merritt phenomenon. Intestinal involvement is uncommon and can cause acute presentations, such as obstruction or gastrointestinal bleeding. A 5-day-old neonate presented with bilious vomiting for 2 days. The tumor was in the jejunum. Histopathological examination with immunohistochemistry of the resected jejunum showed CD34 positive endothelial lined vascular spaces infiltrating from submucosa to serosa, which is classical of kaposiform hemangioendothelioma. There was no deranged coagulation profile. This case forms an interesting cause for neonatal intestinal obstruction.

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A Cholangioblastic Variant of Cholangiocarcinoma

Verhoeff, Kevin MD1; Bacani, Julinor MD2; Fung, Christopher MD3; Canterbury, Laura A. MD2

doi : 10.14309/crj.0000000000000746

February 2022 - Volume 9 - Issue 2 - p e00746

Cholangioblastic variant of cholangiocarcinoma is rare and may be encountered in young adults with a liver mass. On biopsy, the pathologic features may mimic neuroendocrine or other tumors. Increased awareness of this unusual variant and the typical strong expression of the immunohistochemical marker inhibin may help prevent diagnostic errors. Because only a few cases have been reported, we also discuss treatment options in a 26-year-old man.

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Endoscopic Coil Embolization for Refractory Intrahepatic Biliary Duct Leak

Dutra, Barbara MD, RD1; Welborn, Macartney MD1; Thosani, Nirav C. MD, MHA1; Badillo, Ricardo MD1; DaVee, Tomas MD, MSCI1; Bhakta, Dimpal MD1

doi : 10.14309/crj.0000000000000743

February 2022 - Volume 9 - Issue 2 - p e00743

Bile leaks may be seen after blunt and penetrating trauma, as well as iatrogenic injury from surgical procedures. There are many articles on endoscopic treatment options for the management of biliary leaks, including sphincterotomy, endoscopic stent, or nasobiliary drain placement. Data, however, are scarce regarding the management of persistent biliary leaks after the initial intervention. We present a case of endoscopic coil embolization to treat a refractory bile leak after initial endoscopic sphincterotomy and stent placement in a patient with a grade IV liver laceration due to a gunshot wound.

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Isolated Gastritis Secondary to Immune Checkpoint Inhibitors Complicated by Superimposed Cytomegalovirus Infection

Nguyen, Anita H. MD1; Sagvand, Babak Torabi MD2; Hwang, Daniel G. MD2; Legesse, Teklu MD3; Cross, Raymond K. MD, MS, FACG, AGAF2

doi : 10.14309/crj.0000000000000747

February 2022 - Volume 9 - Issue 2 - p e00747

Immune checkpoint inhibitors such as nivolumab increase the T-cell destruction of malignancies but can also trigger a broad variety of immune-related adverse events (irAEs). Colitis as an irAE is well-documented, but upper gastrointestinal tract involvement is primarily unrecognized. We present a patient who developed gastritis as an irAE after multiple cycles of nivolumab and initially responded well to steroid therapy but then developed superimposed cytomegalovirus infection. The similarity between both presentations highlights the importance of having a broad differential diagnosis in patients with gastrointestinal complaints treated with immune checkpoint inhibitors and the need for further studies to better characterize gastritis as an irAE.

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Primary Colonic Diffuse Large B-Cell Lymphoma in Bloom Syndrome

Benanzer, Tessa M. MD1; Kamboj, Amrit K. MD1,2; Sweetser, Seth MD1,2

doi : 10.14309/crj.0000000000000686

February 2022 - Volume 9 - Issue 2 - p e00686

Bloom syndrome is an inherited disorder involving a characteristic phenotype of short stature, photosensitive rash, immunodeficiency, and an early predisposition to various cancers, including lymphoma and colorectal neoplasms. We present a patient with Bloom syndrome found to have a colonic mass secondary to diffuse large B-cell lymphoma highlighting the importance of cancer screening and surveillance in these patients.

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Learning From Highly Effective Teams: What Can We Apply to the Gastrointestinal Endoscopy Unit Team?

McDonald, Nicholas M. MD1

doi : 10.14309/crj.0000000000000745

February 2022 - Volume 9 - Issue 2 - p e00745

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