Dysphagia represents a difficulty in passage of solid or liquid foods from the oral cavity into the stomach and is considered as an alarm symptom of gastrointestinal system. It often indicates an organic disease and needs to be explained. In this paper, a case of 61-year-old man with posterior tongue abscess is presented.

Gulsum Teke Ozgur

Mehmet Volkan Akdogan

Gulhan Kanat Unler

Huseyin Savas Gokturk

A Rare Cause of Acute Dysphagia: Abscess of the Base of the Tongue

Acute pancreatitis (AP) is a condition characterised by the activation of the normally inactive digestive enzymes due to an etiological factor and digestion of the pancreatic tissues, resulting in extensive inflammation and leading to local, regional, and systemic complications in the organism. It may vary from the mild edematous to the hemorrhagic and severely necrotising form. The most common causes are biliary stones and alcohol abuse. In this case study, we would like to present a patient with AP due to hypertriglyceridemia (HPTG), which is a rare cause of pancreatitis, and splenic vein thrombosis, which is a rare complication of pancreatitis.

Ercan G&#xfc;nd&#xfc;z

Recep Dursun

Mustafa &#x130;&#xe7;er

Y&#x131;lmaz Zengin

Cahfer G&#xfc;lo&#x11f;lu

Acute Pancreatitis and Splenic Vein Thrombosis due to Hypertriglyceridemia

Juvenile polyposis syndrome (JPS) is a rare genetic disorder characterized by juvenile polyps of the gastrointestinal tract. We present a new pathogenic mutation of the SMAD4 gene and illustrate the need for a multidisciplinary health care approach to facilitate the correct diagnosis. The patient, a 47-year-old Caucasian woman, was diagnosed with anaemia at the age of 12. During the following 30 years, she developed numerous gastrointestinal polyps. The patient underwent several operations, and suffered chronic abdominal pain, malnutrition, and multiple infections. Screening of the SMAD4 gene revealed a novel, disease-causing mutation. In 2012, the patient suffered hypoalbuminemia and a large polyp in the small bowel was found. Gamma globulin was given but the patient responded with fever and influenza-like symptoms and refused more treatment. The patient underwent surgery in 2014 and made an uneventful recovery. At follow-up two months later albumin was 38&#x2009;g/L and IgG was 6.9&#x2009;g/L. Accurate diagnosis is essential for medical care. For patients with complex symptomatology, often with rare diseases, this is best provided by multidisciplinary teams including representatives from clinical genetics. Patients with a SMAD4 mutation should be followed up both for JPS and haemorrhagic hereditary telangiectasia and may develop protein loosing enteropathy and immunodeficiency.

Joel Johansson

Christofer Sahin

Rebecka Pestoff

Simone Ignatova

Pia Forsberg

Anders Edsj&#xf6;

Mattias Ekstedt

Marie Stenmark Askmalm

A Novel SMAD4 Mutation Causing Severe Juvenile Polyposis Syndrome with Protein Losing Enteropathy, Immunodeficiency, and Hereditary Haemorrhagic Telangiectasia

Littoral cell angioma is a rare vascular tumor of the spleen. The pathogenesis is unknown but the lesion is associated with several malignancies and immunological disorders. The diagnosis requires histopathological examination. The malignant potential of this lesion is unknown, which is why splenectomy is recommend for all cases. Symptomatic cases generally suffer from hypersplenism and pyrexia. A previously healthy 20-year-old female was diagnosed with colonic Crohn&#x2019;s disease; as part of the work-up a magnetic resonance enterography was performed which showed multiple signal changes of the spleen. The patient reported chronic abdominal pain in the left upper quadrant, malaise, and fever. The unknown splenic lesions prompted a laparoscopic splenectomy; pathology revealed a littoral cell angioma. The abdominal pain and malaise remitted but the fever persisted one year despite adequate treatment of the patient&#x2019;s Crohn&#x2019;s disease. Littoral cell angioma is associated with immune-dysregulation including Crohn&#x2019;s disease with several reported cases. Signs and symptoms of hypersplenism and splenic lesions on imaging should raise suspicion of littoral cell angioma in patients with Crohn&#x2019;s disease. Magnetic resonance enterography to assess disease severity in Crohn&#x2019;s disease may provide an opportunity to study the prevalence and natural history of this rare splenic tumor.

Bergthor Bj&#xf6;rnsson

Per Sandstr&#xf6;m

Littoral Cell Angioma in a Patient with Crohn&#x2019;s Disease

Background. Autoimmune pancreatitis (AIP) is an atypical chronic inflammatory pancreatic disease that appears to involve autoimmune mechanisms. In recent years, AIP has presented as a new clinical entity with its protean pancreaticobiliary and systemic presentations. Its unique pathology and overlap of clinical and radiological features and absence of serological markers foster the disease&#x2019;s unique position. We report a case of diffuse type 1 autoimmune pancreatitis with obstructive jaundice managed with biliary sphincterotomy, stent placement, and corticosteroids. A 50-year-old Caucasian woman presented to our hospital with epigastric pain, nausea, vomiting, and jaundice. Workup showed elevated liver function tests (LFT) suggestive of obstructive jaundice, MRCP done showed diffusely enlarged abnormal appearing pancreas with loss of normal lobulated contours, and IgG4 antibody level was 765&#x2009;mg/dL. EUS revealed a diffusely hypoechoic and rounded pancreatic parenchyma with distal common bile duct (CBD) stricture and dilated proximal CBD and common hepatic duct (CHD). ERCP showed tight mid to distal CBD stricture that needed dilatation, sphincterotomy, and placement of stent that led to significant improvement in the symptoms and bilirubin level. Based on clinical, radiological, and immunological findings, a definitive diagnosis of AIP was made. Patient was started on prednisone 40&#x2009;mg/day and she clinically responded in 4 weeks.

Satya Allaparthi

Mohammed Sageer

Mark J. Sterling

Deciphering Autoimmune Pancreatitis, a Great Mimicker: Case Report and Review of the Literature

Primary sclerosing cholangitis is a cholestatic condition with unknown etiology and long-standing, progressive course, leading to cirrhosis and requiring orthotropic liver transplant. In approximately 80&#x25;, primary sclerosing cholangitis is accompanied by inflammatory bowel disease, and in most cases the recognition of bowel disease precedes the diagnosis of primary sclerosing cholangitis. We describe a case of 22-year-old male diagnosed simultaneously with primary sclerosing cholangitis and ulcerative colitis, with a medical history suggesting uncommon prior development of the liver disease. Five months after the initial diagnosis, we observed advanced lesions of bile tree due to progression of primary sclerosing cholangitis, which led to the unusually fast necessity for the orthotopic liver transplant.

Piotr Pardak

Ewa Walczak

Rafa&#x142; S. Filip

Rapid Progression of Primary Sclerosing Cholangitis Complicated with Ulcerative Colitis

Small bowel tumors and other rare intestinal disorders are often exceedingly difficult to identify. Even cutting-edge technologies, such as push enteroscopy and capsule endoscopy, can fail to determine the cause of a patient&#x2019;s symptoms. At our institution magnetic resonance enterography (MRE) has become an increasingly reliable tool in the difficult-to-diagnose or difficult-to-monitor patient. In this retrospective case series, we discuss four patients with four rare intestinal disorders that were successfully diagnosed using MRE after failing to be diagnosed using more routine technologies, such as CT scans and flexible sigmoidoscopies. With the discussion of these four cases we demonstrate that MRE is a useful diagnostic modality in patients whose surveillance is difficult or to diagnose rare colorectal disease phenomena, colloquially referred to as &#x201c;zebras.&#x201d;

Anjali S. Kumar

Jasna Coralic

Reid Vegeler

Kirthi Kolli

John Liang

Allison Estep

Allen P. Chudzinski

James D. McFadden

Magnetic Resonance Enterography: The Test of Choice in Diagnosing Intestinal &#x201C;Zebras&#x201D;

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Case Reports in Gastrointestinal Medicine publishes case reports and case series focusing on gastroenterology, hepatology, pancreas and biliary, and related cancers.

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Case Reports in Gastrointestinal Medicine - Table of contents 2015

Case Reports in Gastrointestinal Medicine | Hindawi

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Case Reports in Gastrointestinal Medicine publishes case reports and case series focusing on gastroenterology, hepatology, pancreas and biliary, and related cancers.

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Case Reports in Gastrointestinal Medicine

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Case Reports in Gastrointestinal Medicine