Eosinophilic enterocolitis is an exceptionally rare condition with few described cases in the literature, representing the least frequent manifestation of the wide spectrum of eosinophilic gastrointestinal disorders. We describe a case of a young male patient presenting with a panmural form of the disease, manifested by abdominal pain, distention, and watery diarrhea with 4 days of evolution, bowel wall thickening, and ascites. Eosinophilic ascites is probably the most unusual presentation form of this entity. It poses a diagnostic challenge because of its nonspecific symptoms, associated with the absence of standardized histological criteria, hence requiring a high level of suspicion. There is also no consensus regarding treatment: it should be individualized according to the patient's age and severity of symptoms.
Undifferentiated carcinoma with osteoclast-like cells is a rare pancreatic neoplasm with unique ultrasound endoscopic features. A59-year-old female presented with a 3-month history of weight loss. Abdominal computed tomography and endoscopic ultrasound showed a large pancreatic tumor with a heterogeneous echotexture and liver metastasis. Endoscopic ultrasound fine needle aspiration was used to establish the diagnosis. In this case report, we review the endoscopic, clinical, and pathological features of this type of tumor and describe for the first time the endoscopic features of real-time elastography and contrast enhancement. Real-time elastography revealed a heterogeneous predominantly blue pattern suggestive of pancreatic malignancy, and the contrast-enhanced endosonography showed a hypervascular mass and distinctive vascular (solid) and avascular (liquid/necrotic) components of the lesion, guiding the fine needle aspiration.
A 6-year-old caucasian girl was observed in the emergency department for fever, odynophagia, anorexia and myalgia. She had past history of elevated creatine kinase (CK) and toe walking till the age of 2, with intermittent CK elevation, and otherwise normal physical examination and basic etiological investigations. She had no other relevant personal or family history, and a normal newborn expanded metabolic screening. At physical examination she was well-appearing but febrile (temperature of 39.3ºC), with dry lips, enanthema, conjunctival hyperemia, bilateral cervical adenopathies and muscular pain. Blood tests revealed mild anemia (hemoglobin level, 11.4 g/dL), and elevation of white blood cell count (12530/uL with 47.7% lymphocytes), CK (2196 U/L), lactate dehydrogenase (649 U/L) and C-reactive protein (1,97 mg/dl). Liver enzymes, urea and creatinine values were normal, as well as urine biochemistry. A rapid Streptococcus pyogenes diagnostic test was negative. Blood serol
A healthy 16-year-old male presented to the emergency department with vomiting and pain in the right iliac fossa for the previous 12 hours, with no other symptoms.
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