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Etiological aspects of intragastric bezoars and its associations to the gastric function implications: A case report and a literature review.
Khan, S, Khan, IA, Ullah, K, Khan, S, Wang, X, Zhu, LP, Rehman, MU, Chen, X, Wang, BM
Medicine. 2018;(27):e11320
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Abstract
RATIONALE Intragastric bezoar is a stony mass found trapped in the stomach, though it can occur in other locations of the gastro-intestinal tract. The etiology of intragastric bezoar is multifactorial, includes certain risk factors and predisposing factors such as coexisting medical disorders, anatomic abnormalities, and gastric motility disorders, which contribute to the development of intragastric bezoar. PATIENT CONCERNS In this report, we present a rare case of intragastric bezoar with epigastric pain after prolonged consumption of jujubes. To our knowledge, this is the first case of intragastric bezoar to be reported after jujubes ingestion. DIAGNOSES An upper gastrointestinal (GI) endoscopy performed which revealed an 8 × 5-cm intragastric diospyrobezoar with an adjacent necrotic pressure ulcer of size 0.8 × 0.5-cm without signs of bleeding. INTERVENTIONS For therapeutic intervention, Coca-Cola ingestion and lithotripsy were applied. OUTCOMES The therapeutic course was uneventful. There was no recurrence during 1-year follow-up. LESSONS In our literature, jujube emerged as a new player. A bezoar composed of unripened fruit content in the stomach, could be the cause of chronic abdominal pain, dyspepsia, gastric reflux or heartburn. Moreover, this study provides a detailed overview of recently published literature regarding intragastric manifestations of bezoar, etiological factors, diagnostic and therapeutic approaches.
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2.
Gastric pyogenic granuloma: Report of two cases and review of the literature.
Val-Bernal, JF, Mayorga, M, Cagigal, ML, Cabezas-González, J
Pathology, research and practice. 2016;(1):68-71
Abstract
Pyogenic granuloma (PG) is a polypoid lobular capillary hemangioma rarely described in the stomach. We report two cases aged 72 and 66 years. A review of the literature on gastric PG, including the present cases, yielded ten patients. There were six males and four females. The age of the patients ranged from 35 to 82 years with a mean of 58.9 years. The lesions were all solitary, except one case of multiple lesions in the corpus and antrum. PG can be located in any part of the stomach. The most common site was the antrum. The mean maximum diameter of the lesions was 14.5mm (range 7-30mm). Most lesions were pedunculated. Pain or discomfort (epigastric, right upper quadrant or chest), upper gastrointestinal bleeding, and melena were the most common clinical symptoms. Iron deficiency anemia was the rule, often requiring blood transfusion. Five patients underwent snare polypectomy, four endoscopic mucosal resection, and one laser irradiation. The follow-up ranged from two weeks to two years. There were no recurrences. Pathologists should be familiar with this condition in order to avoid overdiagnosis as a malignant vascular tumor.
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Sarcina ventriculi of the stomach: a case report.
Ratuapli, SK, Lam-Himlin, DM, Heigh, RI
World journal of gastroenterology. 2013;(14):2282-5
Abstract
Sarcina ventriculi is a Gram positive organism, which has been reported to be found rarely, in the gastric specimens of patients with gastroparesis. Only eight cases of Sarcina, isolated from gastric specimens have been reported so far. Sarcina has been implicated in the development of gastric ulcers, emphysematous gastritis and gastric perforation. We report a case of 73-year-old male, with history of prior Billroth II surgery and truncal vagotomy, who presented for further evaluation of iron deficiency anemia. An upper endoscopy revealed diffuse gastric erythema, along with retained food. Biopsies revealed marked inflammation with ulcer bed formation and presence of Sarcina organisms. The patient was treated with ciprofloxacin and metronidazole for 1 wk, and a repeat endoscopy showed improvement of erythema, along with clearance of Sarcina organisms. Review of reported cases including ours suggests that Sarcina is more frequently an innocent bystander rather than a pathogenic organism. However, given its association with life threatening illness in two reported cases, it may be prudent to treat with antibiotics and anti-ulcer therapy, until further understanding is achieved.
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[Gastric duplication in adults: a case report and literature review].
Medina-Franco, H, Ramírez-Luna, MA, Cabrera-Mendoza, F, Almaguer-Rosales, SG, Guillén-Pérez, F
Revista de gastroenterologia de Mexico. 2011;(3):260-3
Abstract
Duplications of the gastrointestinal tract are a rare congenital malformations that usually presents in the first 2 years of life with symptoms of poor weight gain and abdominal palpable mass. The present is a case report of 41 year-old woman who was evaluated for upper abdominal pain. Upper endoscopy revealed a submucosal mass in the greater curvature of the stomach with initial suspect diagnosis of gastrointestinal stromal tumor. Endoscopic ultrasound confirmed partially cystic submucosal mass which was removed with a distal gastric wedge resection without complications. Histopathological report was congenital gastric duplication.
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5.
Effect of total enterectomy, pancreatectomy, and portal vein ligation on liver function and histology: a case report.
Vivarelli, M, Lauro, A, Cucchetti, A, D'Errico, A, Pironi, L, Pinna, AD
Transplantation proceedings. 2007;(1):300-2
Abstract
Impaired hepatic function and histology have been observed in experimental models of diversion of the portal vein blood inflow from the liver and among patients with intestinal failure. Survival after total enterectomy, pancreatectomy, and portal vein ligation, and the effect of such a condition on liver function have never been reported in humans. Herein a 32-year-old woman with familial adenomatous polyposis and multiple desmoid tumors involving the mesentery and the retroperitoneum underwent total enterectomy and pancreatectomy followed by en bloc transplantation of the stomach, small bowel, and pancreas. Due to early graft failure, the patient underwent graftectomy, ligation of the portal vein, and external drainage of the common bile duct. Liver function tests were checked daily and a liver biopsy performed 15 days after graftectomy. The patient died of a ruptured mycotic aneurysm of the abdominal aorta at 27 days after the graftectomy. Liver function tests remained normal throughout the postoperative period; liver biopsy showed normal hepatic architecture with mild portal inflammation and cholestasis and spotty necrosis. Total enterectomy with pancreatectomy and ligation of the portal vein are compatible with survival in humans (at least in the short term), allowing normal hepatic function with minimal histological alterations to the liver.
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6.
Pyogenic granuloma of the stomach successfully treated by endoscopic resection after transarterial embolization of the feeding artery.
Kusakabe, A, Kato, H, Hayashi, K, Igami, T, Hasegawa, H, Tsuzuki, T, Ueda, R, Mizokami, M
Journal of gastroenterology. 2005;(5):530-5
Abstract
Pyogenic granulomas represent the aquisition of vasodilative granulation tissue in the skin or mucosa. They are extremely rare in the alimentary tract, other than in the oral cavity. Here, we report a case of pyogenic granuloma arising from the gastric mucosa. An 82-year-old man was admitted to our hospital because of melena of more than 3 months, duration. Esophagogastroduodenoscopy (EGD) revealed a 30-mm-diameter semipedunculated lesion with an irregular surface in the fundus of the stomach. During hospitalization, the patient's anemia worsened due to loss of blood from the lesion, with the level of hemoglobin declining to 6 g/dl, and a blood transfusion was required. Because radiological and endoscopic findings indicated the lesion was hypervascular, transarterial embolization of the nutritional artery of the lesion was performed before endoscopic resection of the lesion. One week after the embolotherapy, endoscopic mucosal resection was performed, without any complications, such as massive bleeding. Histological studies of the resected specimen revealed many capillaries of various sizes, lined with plump endothelial cells, and accompanied by acute and chronic inflammatory infiltrates. On the basis of these observations, the lesion was diagnosed as a pyogenic granuloma. One year later, the patient was asymptomatic and there was no evidence of tumor recurrence on follow-up EGD.
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Rupture of the lesser gastric curvature after a Heimlich maneuver.
Gallardo, A, Rosado, R, Ramírez, D, Medina, P, Mezquita, S, Sánchez, J
Surgical endoscopy. 2003;(9):1495
Abstract
BACKGROUND We present a case of lesser gastric curvature injury after a Heimlich maneuver due to obstruction of the breathing tract that was repaired by laparoscopic surgery. METHODS A patient with perforation of the lesser gastric curvature as a result of closed abdominal traumatism was operated on using the laparoscopic approach with the use of four trocars as work openings. With this technique, the diagnosis was confirmed, the injury repaired, and the abdominal cavity washed. RESULTS The postoperative period was favorable and the patient was released from the hospital on day 7 without any complications. CONCLUSIONS Laparoscopic surgery can be technically reproduced in the treatment of gastric injury as a result of closed abdominal traumatism.