by Ana L. Romero Socorro, Jesus Romero, Janice Lee, Abdel-Azez Abu Samak, Unzela Iqbal and Naik Arun
Original Research
Gastric antral vascular ectasia (GAVE) is a vascular malformation that causes upper gastrointestinal bleeding (UGIB). It is often discovered incidentally, and it is usually secondary to iron deficiency anemia due to chronic blood loss. Diagnosis of this pathology is primarily done by endoscopy, with direct visualization of the lesions. Multiple treatment options including medical, endoscopic, or surgical are available. We describe a case of a 69-year-old lady who presented with symptomatic anemia and who was found to have Gastric antral vascular ectasia on endoscopy.
American Journal of Medical Case Reports. 2023, 11(6), 113-115. DOI: 10.12691/ajmcr-11-6-3
Pub. Date: July 11, 2023
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by Ana L. Romero, Jesus Romero, Sherif Elkattawy, Nikhita Sachdeva, Fareeha Abid, Hardik Fichadiya, Muhammad Atif Masood Noori, Islam Younes, Shruti Jesani and Ricardo Rodriguez
Original Research
Caustic ingestion results in a wide range of injuries from mucosal erythema to transmural necrosis and viscus perforation, depending on the nature, amount, and time of contact of the substance with the gastrointestinal mucosa. Esophagogastroduodenoscopy (EGD) is considered the gold standard not only for the diagnosis but also for the guide in management. Here in we report a case of a 44-year-old male who presented to ER with complaints of abdominal pain and coffee ground emesis after ingestion of an acid cleaner in the setting of a suicide attempt. CT chest and abdomen demonstrated a small amount of fluid around the distal esophagus and diffuse gastric sub-mucosal edema with no pneumo-mediastinum. EGD showed severe caustic esophagitis and necrosis, gastritis, and mucosal necrosis. Gradually patient transitioned from parenteral nutrition to a liquid diet. Given patient continued to have symptoms of dysphagia, a follow-up EGD was performed which showed erosive esophagitis and severe intrinsic stenosis 26.5 cm from the incisors. The patient underwent gastrostomy as an attempt failed to traverse the stenosis. Post-procedure, the patient started spiking fever with leukocytosis and was found to have an intra-abdominal abscess as evidenced by CT abdomen for which he had emergent laparotomy and evacuation of abdominal abscess and replacement of gastrostomy tube. This case represents the complicated nature of ingesting acidic fluid. It also highlights the importance of considering of overall worse prognosis with that of alkali as compared to acid.
American Journal of Medical Case Reports. 2023, 11(6), 110-112. DOI: 10.12691/ajmcr-11-6-2
Pub. Date: July 11, 2023
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by Brunda MS, Shyma Shaji, Vandana AM and Sivanesh Sekar
Case Report
INTRODUCTION: Pulmonary nocardiosis is defined as pneumonia caused by Genus Nocardia (aerobic actinomycetes). Nocardiosis, caused by Gram-positive, weakly acid-fast, filamentous aerobic actinomycetes, is an opportunistic infection and remains as a possible cause of pulmonary and systemic infection in immunocompromised patients It is a rare condition in an immune-competent patients. METHODS: A prospective observational study was conducted in Aster CMI Hospital, Bengaluru. We prospectively examined the demographics, treatment related variables (including complications) and outcomes. RESULT: A 70-year-old female patient, experienced with a cough with expectoration, dyspnea, weight loss and recurrent sharp rise in body temperature. The diagnosis of nocardiosis is done by microscopic tests like Broncho alveolar lavage fluid and revealed filamentous Gram-positive bacteria Broncho alveolar lavage fluid aerobic culture showed Nocardia species. The patient was treated with Cotrimoxazole and Imipenem. The patient ameliorate both clinically and radiographically.
American Journal of Medical Case Reports. 2023, 11(6), 107-109. DOI: 10.12691/ajmcr-11-6-1
Pub. Date: June 30, 2023