Clinical Image

Fully Covered Self-Expandable Metal Stent Placed Over a Colon Anastomosis in an Animal Model – A Pilot Study of Colon-Metabolism Over the Stent

1. Abstract 1.1. Introduction: Anastomotic leakage in colorectal resection and primary anastomosis is a common and feared complication. Fully Covered Self Expandable Metal Stents (FCSEMS) have been used for treatment of anastomotic leakage. It is still unknown if FCSEMS affect anastomosis healing negatively by causing ischemia. In an animal study we investigated the metabolic effects …

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An Uncommon Complication of Peptic Ulcer Disease

Clinical Image A 52-year-old man with schizophrenia was admitted owing to symptoms of bleeding at the lumen of the upper part of the gastrointestinal tract. Emergency gastroscopy revealed a large penetrating ulcer on the anterior gastric wall, with symptoms of previous bleeding. Intensive conservative treatment was performed. During control gastroscopy three days later, a gastroscope …

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The Clinical Utility of SPECT/CT Hybrid Imaging on Bleeding Meckel’s Diverticulum in Adults: A Case Report

1. Abstract Meckel’s diverticulum is a common malformation of the gastrointestinal tract. Technetium-99m (99mTc) pertechnetate planar scintigraphy is the procedure of choice to localize ectopic gastric mucosa. On the other hand, single photon emission computed tomography/computed tomography (SPECT/CT) imaging comes up with more precise landmarks and scintigraphic findings. We present a case where SPECT/CT provided …

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Resection of Fourth Segment of Liver as a Cause of Hepatoblastoma in A 8 Month- Old-Boy

1. Abstract Intraductal papillary neoplasia of the bile ducts (IPN-B) is a rare intracanal tumor characterized by papillary proliferation of the biliary epithelium responsible for more or less abundant production of mucus, causing dilation of the duct [1]. IPN-B is the “biliary” equivalent of TIPMP. MRI cholangiography and transcutaneous abdominal ultrasound are the best examinations …

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Pneumobilia

1. Clinical Image A 71-year-old man presented to the emergency department with a seven-day history of intermittent fever, middle and right upper abdominal pain, and general malaise. The physical examination of the abdomen was normal. Ten years ago he underwent open cholecystectomy and stone removal from common bile duct by endoscopic retrograde cholangiopancreatography (ERCP). At …

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Concurrent Gastric Hyperplastic and Fundic Gland Polyps in a Patient Taking Proton-Pump Inhibitor

1. Clinical Image A 61-year-old man presented with iron-deficiency anemia (hemoglobin, 8.1 g/dl). He had been taking warfarin and low-dose aspirin for atrial fibrillation and post mitral valve replacement. He had also taken 15 mg lansoprazole daily for 6 years for treatment of gastroesophageal reflux disease. Serum anti-Helicobacter pylori IgG antibody and H. pylori testing …

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Synchronous Triple Colorectal Cancer with Intestinal Obstruction in an Elderly Patient: Rare Case of Malignancy of the Large Intestine

1. Clinical Image Synchronous cancers are characterized by the simultaneous occurrence of multiple primary tumors in the same patient. Synchronous malignancies most commonly occur in the colon, with a high prevalence in elderly patients [1,2]. The occurrence of synchronous colorectal cancers is extremely rare and may be identified at any location within the large intestine …

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Alagille Syndrome: Not Always Hepatic Involvement

1. Clinical Image We present a 22-month-old girl affected by surgical palliative corrected Tetralogy of Fallot and peculiar facial features characterized by prominent forehead, deep-set eyes, pointed chin and bulbous tip of nose (Figure 1) typical of Alagille Syndrome (AS). Hypoplasia of the distal phalanges of both feet and two butterfly vertebrae at D10-D11 on …

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Wire Swallowing: A Purging Behavior

1. Clinical ImagePurging is a self-inflicted behavior, to ridding the body of food consumed in order to lose weight or prevent weight gain. Self-induced vomiting, laxative abuse, diuretic abuse, enemas and excessive exercise are well-known purging behaviors. Purging disorder affects 2.5-4.8% of adolescent females; the behavior mostly affects physiologically and potentiates physical harm [1, 2]. …

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