Gastric cancer is one of the most common diseases globally. Total gastrectomy is often performed surgically. However, late-stage anastomotic passage obstruction after total gastrectomy is relatively rare. Here, we report a case involving a 73-year-old male patient who experienced repeated aspiration pneumonia due to anastomotic passage obstruction 22 years after a total gastrectomy for gastric cancer. He was eventually hospitalized in the Department of Gastroenterology at our hospital because of difficulty eating. Computed tomography revealed prominent dilation of the esophagus and the blind e ..read more

Nasogastric tube syndrome (NGTS) induced by a nasointestinal ileus tube is an uncommon but potentially life-threatening complication. NGTS often becomes serious and progresses to acute upper airway obstruction caused by bilateral vocal cord paralysis or laryngeal infection. Early detection and proper treatment of NGTS are necessary. We describe the case of a 78-year-old patient with this syndrome induced by a nasointestinal ileus tube. At administration, ileus was suspected based on physical examination and thoracoabdominal X-ray findings. A nasointestinal ileus tube was placed through the lef ..read more

Glomus tumor (glomus cell tumor) is a rare, often benign neoplasm, which is, in most cases, seen as a solitary bluish nodule involving the nail beds. Solid glomus tumor, glomangioma, and glomangiomyoma are the three main histopathological variants. In this case report, we present the rarest subtype of a glomus tumor, glomangiomyoma, in an atypical location: the stomach. A 45-year-old female from Syria presented to the clinic with severe dizziness and left epigastric abdominal pain accompanied by melena. We performed a thorough clinical study, laboratory workup, upper gastrointestinal endoscopy ..read more

Sprue-like enteropathy (SLE) is a clinical syndrome similar to celiac disease and has been associated with the use of various angiotensin receptor blockers (ARBs), a class of medications frequently used in the management of hypertension. Currently, there has only been one documented case report which has observed this occurrence with the use of the ARB candesartan. A 90-year-old female patient presented with chronic diarrhea and weight loss of unclear etiology. Diagnostic esophagogastroduodenoscopy and ileocolonoscopy were macroscopically unremarkable, but histological samples revealed complet ..read more

The diagnosis of carcinoid heart disease as a cause of ascites can be hard to establish. We report a patient with well-differentiated neuroendocrine neoplasm of the liver who presented with high serum ascites albumin gradient and high protein ascites due to carcinoid heart disease (CHD). As ascites caused by CHD are rare, the etiology can easily be overlooked, especially in the setting of alcohol use disorder and portal hypertension. Through our case report, we emphasize the importance of physical examination and peritoneal fluid analysis in the diagnosis of CHD. As the management of CHD requi ..read more

Zellweger spectrum disorders (ZSDs) are known to present with variable hepatic manifestations ranging from benign hepatosplenomegaly and elevated liver enzymes to advanced liver cirrhosis with hepatocellular carcinoma. However, the progression of liver disease in ZSD patients over time is poorly characterized due to scarcity of the disease. Herein, we report a case of newly diagnosed liver cirrhosis in a ZSD patient with rapid progression and fatal outcome to demonstrate key clinical learning points. Case Rep Gastroenterol 2023;17:168–171 ..read more

We treated a 39-year-old Japanese man who was admitted for an abdominal mass. He had had neurofibroma-like skin lesions since childhood. Computed tomography and endoscopic ultrasound results were consistent with a tumor in the small intestine. Although the tumor was undetectable by single-balloon endoscopy, the patient’s background and imaging results led us to suspect a gastrointestinal stromal tumor (GIST). He also met the diagnostic criteria for neurofibroma type 1 (NF1). We performed a surgical removal of the tumor, and the biopsy results led to a definitive diagnosis of GIST. Small bowel ..read more

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis of small to medium vessels. Gastrointestinal involvement is uncommon and is associated with higher mortality. Treatment is based on empiric evidence. In this article, we report a case of EGPA-related pancolitis and stricturing small bowel disease managed with a combination of mepolizumab and surgical resection. Case Rep Gastroenterol 2023;17:155–159 ..read more

We report a case of a 70-year-old male with delayed perforation in the cecum treated by endoscopic ultrasonography-guided drainage for a pelvic abscess. The lesion was a 50-mm laterally spreading tumor, and endoscopic submucosal dissection (ESD) was performed. No perforation was detected during the operation, and en bloc resection was achieved. He had fever and abdominal pain on postoperative day (POD) 2. Computed tomography (CT) revealed the intra-abdominal free air, leading to a diagnosis of delayed perforation after ESD. Vital signs were stable, the perforation was considered minor, and end ..read more

Leukocytoclastic vasculitis (LCV) is rarely associated with anti-tumor necrosis factor [TNF] α therapy. We report a 22-year-old man with new onset of a pustular rash on his bilateral upper and lower extremities while on adalimumab therapy for Crohn’s disease. Skin biopsy of the affected area showed perivascular extravasation of erythrocytes, neutrophils, eosinophils and vascular damage surrounding blood vessels associated with fibrin, consistent with LCV. Patient was treated with topical steroids and subsequently transitioned to ustekinumab therapy with follow-up colonoscopy showing minimal ac ..read more