We report a case of acute pancreatitis after an elective screening colonoscopy. A 51-year-old male with a left ventricular assist device for end-stage nonischemic cardiomyopathy and a family history of colorectal cancer was admitted for an expedited heart transplant evaluation. He underwent screening colonoscopy during this admission which was technically uncomplicated apart from requiring slight maneuvering at the splenic flexure. The following day, the patient developed acute epigastric pain and one episode of emesis. Subsequent laboratory evaluation revealed a significantly elevated lipase level and cross-sectional imaging consistent with acute pancreatitis. With no evidence of gallstones, alcohol use, and hypertriglyceridemia, the acute pancreatitis was deemed to be a complication of colonoscopy. The presumed mechanism of the pancreatitis was due to mechanical trauma from insufflation and abdominal pressure, applied to at the splenic flexure, which is in close proximity to the pancreatic tail. The patient was treated with supportive care (intravenous fluid, analgesia, and pancreatic rest) and improved significantly over a three-day period.

Sahil D. Doshi

Yelina Alvarez

Shria Kumar

Octavia Pickett-Blakely

Acute Pancreatitis after Colonoscopy: A Case Presentation and Literature Review

Cystic pancreatic neuroendocrine tumors represent around 13&#x25; of all neuroendocrine tumors (Hurtado-Pardo 2017). There has been an increase in the incidence of cases due to improvement in imaging modalities. This is a case of a 68-year-old male with the incidental finding of a pancreatic cyst on CT. Initial Endoscopic Ultrasound with Fine Needle Aspiration (EUS-FNA) showed sonographic and cytology features suggestive of a pancreatic pseudocyst. However the cyst persisted with no change in size after aspiration leading to a follow-up EUS- FNA, which was combined with needle based confocal laser endomicroscopy (nCLE). The nCLE features were consistent with a cystic pancreatic neuroendocrine tumor, which was later confirmed on histology after surgical resection.

Iqra Haq

Somashekar G. Krishna

Bhaveshkumar Patel

Thavam Thambi-Pillai

Chencheng Xie

Karah Odegaard

Kimberlee Buohy

Muslim Atiq

The Impact of Repeating Endosonography with Confocal Endomicroscopy for the Diagnosis of Cystic Neuroendocrine Tumor

Achalasia is an intrinsic disorder of the esophagus that results from loss of ganglion cells in the lower esophageal sphincter. Clinically it is manifested by dysphagia to solids and liquids, weight loss, regurgitation, and chest pain. Pseudoachalasia, in contrast, is a rare entity that causes identical symptoms, but has a divergent underlying pathogenesis. The symptomology in these cases oftentimes occurs secondary to extrinsic compression of the esophagus, mostly attributable to malignancy. Although many cases of extrinsic esophageal compression have been reported in the literature, rarely has this occurred secondary to Burkitt&#x2019;s lymphoma in an adult. Here, we present a case of Burkitt&#x2019;s lymphoma resulting in pseudoachalasia in a 70-year-old female. The concurrence of these two entities in one patient makes this case presentation especially rare.

Eric Omar Then

Andrew Ofosu

Prashanth Rawla

Tagore Sunkara

Sriharsha Dadana

Andrea Culliford

Vinaya Gaduputi

Burkitt&#x2019;s Lymphoma of the Gastrohepatic Omentum: A Malignant Presentation of Pseudoachalasia

Actinomyces species are Gram positive anaerobic or microaerophilic bacteria that are part of the human flora in the oropharyngeal, gastrointestinal, and genitourinary tract. In the presence of a mucosal injury, they can become pathogenic and infect the underlying tissue without respect for tissue planes, leading to abscesses, fistulas, and sinus tracts. Through contiguous and hematogenous spread, virtually any organ can become infected. The presentation can be myriad and often mimics tumors, tuberculosis, or other more common infections and inflammatory conditions. While the cervicofacial region is the most common site of infection, involvement of the esophagus is unusual. Esophageal actinomycosis mostly occurs in patients with compromised immunity or prior esophageal injuries. Occurrence in immunocompetent individuals without risk factors is exceedingly rare. We report a case of esophageal actinomycosis complicated by an esophageal stricture in a patient with no apparent predisposing conditions.

Allison N. Zhang

Debra Guss

Smruti R. Mohanty

Esophageal Stricture Caused by Actinomyces in a Patient with No Apparent Predisposing Factors

Fecal microbiota transplantation (FMT) is a novel strategy for the therapy of dysbiosis-associated disorders via modulation of the gut microbiota. Intestinal dysbiosis is associated not only with digestive disorders, but also with a variety of extra-digestive disorders. A worldwide increasing number of FMT can be expected in the future as well as an increase in adverse events. We describe the case of a patient with chronic radiation colitis that developed adhesion ileus 2 days after FMT. Since these problems never occured before and the short time interval favours a causality, we speculate about FMT-induced alterations in gut motility causing a &#x201c;trapping&#x201d; of the small intestine in an adhesion and other mechanisms beyond &#x201c;pure&#x201d; coincidence.

Igor Alexander Harsch

Peter Christopher Konturek

Adhesion Ileus after Fecal Microbiota Transplantation in Long-Standing Radiation Colitis

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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 2019

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