Benign pancreatic hyperenzymemia (BPH) or Gullo's Syndrome is a persistent elevation of pancreatic enzymes activity, observed for at least one year, with no pancreatic disorder. This diagnosis is extremely important because it allows us to avoid many unnecessary examinations performed during the diagnostic process. The case is presented of a 25-year-old man who was examined for recurrent elevated lipase and amylase serum values over a time period of 2 years who presented with non-specific abdominal complaints. Interestingly, his routine tests showed sustained elevated serum amylase and lipase activity. He was intensively diagnosed due to pancreatic hyperenzymemia, but no pancreatic disease was detected. The observation lasted two years. The serum lipase and serum amylase levels continued to increase after that time. This diagnosis requires attention because BPH can be the first symptom of pancreatic cancer.
We report a rare case of Peutz-Jeghers syndrome (PJS) in a 35-year-old female. The patient was diagnosed with PJS when she was 11 years old. She has remained under observation since then. We strongly believe that PJS is a very rare diagnosis. However, it can have serious complications such as the intussusception we observed in our patient. Her condition (recurrent abdominal pain and vomiting) in childhood required further diagnostic procedures. Although the diagnosis of PJS was made, among many resected polyps, one of them appeared to be a juvenile polyp. The diagnosis was confirmed in the histopathology report, which was incredibly unique. Genetic testing revealed LKB1/STK11 gene mutation. Clinicians should be aware of the malignant potential in the course of PJS. Hence, these patients require tailor-made management, long-term follow-up, and our particular attention.
Osler-Weber-Rendu disease, also known as hereditary hemorrhagic telangiectasia (HHT), is a rare, autosomal dominant condition that affects approximately 1 in 5000 patients causing abnormal blood vessel formation. HHT patients have mucocutaneous telangiectasias and arteriovenous malformations in various organs. The most prominent symptom of HHT is epistaxis, which, together with gastrointestinal bleeding, may cause iron deficiency anemia. This study is a case report of a 62-year-old patient who was admitted to the Department of Gastroenterology due to acute upper gastrointestinal bleeding and a history of recurrent epistaxis and melena for 4 days, which was confirmed in digital rectal examination. Urgent upper gastrointestinal endoscopy revealed active bleeding from multiple angioectatic spots with bright-looking salmon-colored patches in the antrum and the body suggestive of HHT. The bleeding from two angioectatic spots was stopped by argon plasma coagulation, and four clips were placed to provide good hemostasis. The patient was treated with a proton pomp inhibitor infusion and iron infusion. She was discharged with no signs of GI bleeding, normalized iron levels and a diagnosis of HHT. She was referred to further genetic testing, including evaluation of first-degree relatives. She also had performed unenhanced thin-cut computed tomography (CT) with angiography to exclude the presence of pulmonary arteriovenous malformations (PAVMs). Due to the fact that the patient did not manifest any other HHT-related symptoms and that the instrumental screening discloses no silent AVMs in other organs, the “watch-and-wait strategy” was applied. Although, Osler-Weber-Rendu syndrome is widely described in the medical literature, effective treatment of gastrointestinal telangiectasias is not always available and still lacks standardization to date, which makes the management of gastroenterological involvement still a challenging issue.
Introduction Inflammatory bowel disease (IBD) in most cases is classified into Crohn’s disease (CD) or ulcerative colitis (UC). It appears in 25-35 years of age and the second peak is after fifties. It is very rare to recognize it in the elderly. Case presentation We present a case of a 79-year-old female patient who was admitted to the Chair and Department of Gastroenterology with Endoscopic Unit at the Medical University of Lublin in December 2018 with an acute lower gastrointestinal hemorrhage and dyselectrolytemia. Additionally, she suffered from atrial fibrillation. She has been treated with an anticoagulant therapy and has been receiving dabigatran for many years. After 16 days of diagnostic research and intensive treatment the patient was discharged home with no previous symptoms. After the next 12 days at home our patient returned to the hospital with recurrent gastrointestinal bleeding, abdominal pain and after fainting episode. Digital rectal exam was positive and laboratory test showed anemia again. Colonoscopic findings on admission showed proximally to the splenic flexure blood signs, on Bauhin’s valve a flat ulcer. The histopathological report confirmed the inflammatory bowel disease. After diagnosis of IBD, an effective treatment with mesalazine and prednisone was started. Conclusions Despite the newest clinical trials are more and more common in Crohn’s disease or ulcerative colitis, the elderly patients are mostly excluded from them because of the other accompanying diseases and their burdensome side effects. Choosing the right therapy becomes the main problem in these patients after setting a proper diagnosis which can take years and many unnecessary hospitalizations.
No abstract
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.